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Am J Hum Biol. 2018 May;30(3):e23106. doi: 10.1002/ajhb.23106. Epub 2018 Apr 16.

Reproductive health, obesity, and cardiometabolic risk factors among Samoan women.

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Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island 02912.
Department of Epidemiology and International Health Institute, Brown University School of Public Health, Providence, Rhode Island 02912.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut 06520.
Department of Obstetrics and Gynecology, Tupua Tamasese Meaole Hospital, National Health Service, Government of Samoa, Apia, Samoa.
Bureau of Statistics, Government of Samoa, Apia, Samoa.
Ministry of Health, Government of Samoa, Apia, Samoa.



Obesity leads to deleterious effects on not only cardiovascular health but also on the reproductive health of women. We estimate the prevalence of menstrual irregularity and of polycystic ovarian syndrome (PCOS) in Samoan women, among whom obesity prevalence is extremely high. We explore the association of these reproductive health conditions with adiposity, cardiometabolic risk factors, and androgen levels.


A cross-sectional sample of Samoan women 25-39 years of age (n = 470) from a larger population-based genome-wide association study of adiposity and cardiometabolic disease was assessed for the prevalence of oligomenorrhea/amenorrhea (OM/AM) using a self-reported questionnaire. Serum androgens and anti-Müllerian hormone levels were assayed to determine hyperandrogenemia and presence of polycystic ovaries (PCO), respectively, using criterion values. PCOS was classified using NIH guidelines of having at least two of the three conditions: menstrual irregularity, hyperandrogenism, and PCO. We contrasted socio-demographic, reproductive health, and cardiometabolic risk factors between those with and without OM/AM and similarly for PCOS.


The prevalence of OM/AM was 7.4% (95% CI: 5.1, 9.8), and women with OM/AM had significantly higher central adiposity. PCOS was estimated at 6.8% (95% CI: 4.5, 9.1), and those with PCOS were younger but had higher overall and central adiposity measures, higher triglycerides, and higher prevalence of insulin resistance than women without PCOS.


The prevalence of menstrual irregularity and PCOS are less than hypothesized given the high levels of adiposity in this population. Nevertheless, Samoan women with menstrual irregularity and other features of PCOS have significantly poorer metabolic health.

[Available on 2019-05-01]

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