Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis

Skiba, Marina; Islam, Rezwan; Bell, Robin J.; Davis, Susan Ruth

doi:10.1093/humupd/dmy022

Cited by 161 publications

(130 citation statements)

References 68 publications

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“…PCOS has a significant prevalence worldwide, with reports of up to 20% of women of reproductive age being affected by the condition, which poses a high economic health burden (March et al 2010, Dumesic et al 2015, Bozdag et al 2016, Skiba et al 2018. PCOS women suffer from a wide range of ill-health traits, which include endocrine, reproductive, metabolic and psychological features.…”

Section: Defining Polycystic Ovary Syndrome (Pcos) and Evidence To Sumentioning

confidence: 99%

Androgens and ovarian function: translation from basic discovery research to clinical impact

Walters

Paris

Aflatounian

et al. 2019

Journal of Endocrinology

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In the last decade, it has been revealed that androgens play a direct and important role in regulating female reproductive function. Androgens mediate their actions via the androgen receptor (AR), and global and cell-specific Ar-knockout mouse models have confirmed that AR-mediated androgen actions play a role in regulating female fertility and follicle health, development and ovulation. This knowledge, along with the clinical data reporting a beneficial effect of androgens or androgen-modulating agents in augmenting in vitro fertilization (IVF) stimulation in women termed poor responders, has supported the adoption of this concept in many IVF clinics worldwide. On the other hand, substantial evidence from human and animal studies now supports the hypothesis that androgens in excess, acting via the AR, play a key role in the origins of polycystic ovary syndrome (PCOS). The identification of the target sites of these AR actions and the molecular mechanisms involved in underpinning the development of PCOS is essential to provide the knowledge required for the future development of novel, mechanism-based therapies for the treatment of PCOS. This review will summarize the basic scientific discoveries that have enhanced our knowledge of the roles of androgens in female reproductive function, discuss the impact these findings have had in the clinic and how a greater understanding of the role androgens play in female physiology may shape the future development of effective strategies to improve IVF outcomes in poor responders and the amelioration of symptoms in patients with PCOS.

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Section: Defining Polycystic Ovary Syndrome (Pcos) and Evidence To Sumentioning

confidence: 99%

Androgens and ovarian function: translation from basic discovery research to clinical impact

Walters

Paris

Aflatounian

et al. 2019

Journal of Endocrinology

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Section: Introductionmentioning

confidence: 99%

“…Polycystic ovary syndrome (PCOS) has a prevalence ranging from 5 to 20% in women of reproductive age, depending on the population and criteria used for making a definitive diagnosis (1,2). The use of ultrasound may increase PCOS prevalence by two to threefold and adds two more phenotypes (1). As the criteria used for the diagnosis of PCOS may decrease, or even normalize, during the reproductive lifetime, the prevalence of PCOS seems to decrease with age (2).…”

Section: Introductionmentioning

confidence: 99%

“…Biochemical hyperandrogenism, the clue criterion for the diagnoses of PCOS, seems to decrease with aging and this is an important issue in the clinical practice (1,4,5,6). According the Rotterdam criteria, the ovarian morphology, or size, is also important for PCOS diagnoses, and it is known that the ovary reaches its maximum volume at 1.2-3.8 years after menarche (7).…”

Section: Introductionmentioning

confidence: 99%

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Changes in clinical and biochemical characteristics of polycystic ovary syndrome with advancing age

Medeiros

Yamamoto

Medeiros

et al. 2020

Endocrine Connections

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Objective To verify whether aging can modify the clinical and biochemical characteristics of women with polycystic ovary syndrome (PCOS). Material and methods This observational cross-sectional study was conducted at the reproductive endocrinology clinics of Julio Muller University Hospital and Tropical Institute of Reproductive Medicine in Cuiabá, MT, Brazil, between 2003 and 2017. Both, 796 PCOS and 444 non-PCOS normal cycling women underwent the same examination. PCOS was diagnosed using the Rotterdam criteria as recommended for adolescent and adult subjects. Anthropometric, metabolic, and endocrinological modifications with aging were initially examined in the two groups: control and PCOS. Further analyses were performed after a 5-year age stratification of data throughout the reproductive period. All participants signed a consent form approved by the local ethical committee. Results Biomarkers of adiposity were more remarkable in African descendant PCOS women. Body weight, waist/hip ratio, fat mass, and BMI were higher in PCOS women and tended to increase at all 5 age-strata, between ≤19 and 35 years of age. Serum androgen levels decreased with aging, markedly in PCOS subjects (P < 0.01 for all age-strata comparisons), but remained elevated when compared with the levels found in controls. Carbohydrate markers, triglycerides, and total cholesterol tended to increase over time in PCOS (P < 0.01 for all age-strata comparisons). Total cholesterol also tended to increase with age in non-PCOS women (P = 0.041). Conclusion The present study has shown that the advancing age influences many features of PCOS women. Biochemical hyperandrogenism, the core criterion recommended in the current systems to define the syndrome, showed statistically significant tendencies to decrease with aging progression but did not normalize. The use of age-adjusted features for the diagnosis of PCOS are recommended.

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“…4,6 Depending on the diagnostic criteria used, 7,8 PCOS affects 6% to 18% of women worldwide in their reproductive years. 2,9 In the Middle East, the prevalence of PCOS is equally high and ranges from 5% based on the National Institutes of Health criteria, to 19% based on the Rotterdam consensus criteria. [10][11][12][13] Several studies have reported a link between PCOS and reduced health-related quality of life (HRQoL).…”

Section: Introductionmentioning

confidence: 99%

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

Alhussain¹,

AlRuthia²,

Al‐Mandeel³

et al. 2020

PPA

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Background: Metformin is commonly prescribed to manage polycystic ovary syndrome (PCOS), which is one of the most common endocrine disorders among women of childbearing age and is associated with high prevalence rates of depression and anxiety.Objective: This study's objective was to determine the impact of prescribed metformin on depression and anxiety levels of patients with PCOS. Methods: This prospective, multi-center, cohort study examined the impact of prescribed metformin on the depression and anxiety of women with PCOS in four gynecology clinics in Saudi Arabia and Jordan. The women had recently been prescribed metformin along with lifestyle modifications, such as diet and exercise, and were compared to another group of women with PCOS who were prescribed lifestyle modifications only. Depression and anxiety were assessed at baseline and three months later using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Health-related quality of life was measured using the Short Form Health Survey (SF-36). Multiple logistic regression analyses were conducted to examine the impact of metformin on depression and anxiety. Results: Eighty-six women participated in the study: 53 were prescribed metformin with lifestyle modifications, and 33 were prescribed lifestyle modifications only. The women on metformin had 70% lower odds of having major depression (PHQ-9≥10) (OR=0.302, P=0.045); however, no significant effect of metformin on anxiety (GAD-7≥10) was found. Conclusion: Metformin may have a role in the management of depression symptoms among patients with PCOS; however, its potential antidepressant effect should be further examined in randomized double-blind placebo-controlled clinical trials.

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Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis

Cited by 161 publications

References 68 publications

Androgens and ovarian function: translation from basic discovery research to clinical impact

Androgens and ovarian function: translation from basic discovery research to clinical impact

Changes in clinical and biochemical characteristics of polycystic ovary syndrome with advancing age

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

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