POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: Epidemiological aspects of polycystic ovary syndrome.

In Brief: PCOS is one of the most common endocrine disorders in reproductive-aged women, causing diverse clinical manifestations with significant long-term health impacts. This review provides contemporary epidemiological evidence on PCOS outcomes while highlighting methodological limitations and research priorities.

Abstract: Polycystic ovary syndrome (PCOS) affects 10-13% of women worldwide and is characterized by metabolic, reproductive, dermatological and psychological manifestations with long-term health implications.

The PCOS Phenotypes in Unselected Populations (P-PUP) study: participant clinical features and data harmonization on analysis of individual participant data.

Background: Polycystic ovary syndrome (PCOS) is a multifaceted condition with diagnostic challenges and clinical heterogeneity across populations. Research priorities include enhanced accuracy in defining cut-offs for diagnostic features. Here, we aim to describe participant clinical features and data harmonization in the international PCOS Phenotype in Unselected Populations (P-PUP) study.

Cardiometabolic Risk in First Degree Relatives of Women With Polycystic Ovary Syndrome (PCOS).

Objective: Polycystic ovary syndrome (PCOS) is a common multisystem disorder with reproductive, cardiometabolic and psychological implications. Genetic factors play a role in the pathogenesis of PCOS. We sought to investigate the cardiometabolic health of first degree relatives (FDR) of women with PCOS.

Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review.

Context: Polycystic ovary syndrome (PCOS) affects up to one-in-five reproductive-aged women and its global healthcare-related economic burden is substantial. The aim of this review was to summarise evidence of the cost-effectiveness of interventions related to the treatment of women with PCOS.

Evidence Acquisition: Six academic databases were systematically searched for relevant records.

Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis.

Background: Polycystic ovary syndrome (PCOS) has been associated with a high prevalence of obstructive sleep apnea syndrome (OSAS). However, the impact of OSAS on the PCOS symptom profile remains unclear. This systematic review and meta-analysis, which informed the 2023 International Evidence-based PCOS Guideline, aims to assess the prevalence and related symptoms of OSAS among females with and without PCOS.

Assessing the coverage of PubMed, Embase, OpenAlex, and Semantic Scholar for automated single-database searches in living guideline evidence surveillance: a case study of the international polycystic ovary syndrome guidelines 2023.

Objectives: Living guideline maintenance is underpinned by manual approaches toward evidence retrieval, limiting long-term sustainability. Our study aimed to evaluate the feasibility of using only PubMed, Embase, OpenAlex, or Semantic Scholar in automatically retrieving articles that were included in a high-quality international guideline - the 2023 international polycystic ovary syndrome (PCOS) guidelines.

Methods: The digital object identifiers (DOIs) and PubMed ID (PMIDs) of articles included after full-text screening in the 2023 international PCOS guidelines were extracted.

Approach to the Patient: Hirsutism.

Hirsutism affects approximately 10% of women globally, with significant economic and quality of life impact. Facial and body terminal hair growth in a male-like pattern is determined by a number of factors, including circulating androgens, and tissue androgen receptor, 5α-reductase, 3α- and 17β-hydroxysteroid dehydrogenase, and ornithine decarboxylase content. The presence of hirsutism is usually determined by the modified Ferriman Gallwey (mFG) visual scale, assessing the amount of terminal hair at nine body sites (upper lip, chin, chest, upper and lower back, upper and lower abdomen, upper arms and thighs).

International evidence-based recommendations for polycystic ovary syndrome in adolescents.

Background: During adolescence, accurate diagnostic criteria and/or identification of adolescents "at risk" of polycystic ovary syndrome (PCOS) are critical to establish appropriate screening, treatment, and lifelong health plans. The 2023 International Evidence-Based Guideline for PCOS aimed to provide the most up-to-date evidence-based recommendations to improve health outcomes for individuals with PCOS, emphasizing accurate and timely diagnosis of PCOS from adolescence.

Methods: The best practice methods following the Appraisal of Guidelines for Research and Evaluation (AGREE-II) criteria were applied.

The PCOS Phenotype in Unselected Populations study: ethnic variation in population-based normative cut-offs for defining hirsutism.

Objective: Hirsutism, a diagnostic feature of polycystic ovary syndrome (PCOS), is often defined using arbitrary percentile cutoffs, rather than normative cutoffs from population-based data. We aimed to define normative cutoffs for hirsutism in diverse populations.

Design: Unselected population-based cluster analysis of individual participant data (IPD).

Key standards and principles for developing evidence-based clinical guidelines: balancing health professional, patient, funder, and government needs.

Clinical practice guidelines are critical tools to inform healthcare decision-making, yet development faces significant challenges in ensuring rigorous, reliable, and globally applicable recommendations. This review examines the essential standards and evolving approaches for creating high-quality, evidence-based guidelines that can effectively support clinical practice across diverse healthcare settings. Key standards for high-quality clinical practice guideline development emerge from leading global health organizations, emphasizing several critical components-establishing a multidisciplinary development group, defining a clear and relevant scope, conducting systematic evidence reviews and meta-analyses, and ensuring transparency throughout the development process.

Approach to the Patient: Diagnostic Challenges in the Workup for Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) affects 10% to 13% of women globally. It is a condition with metabolic, reproductive, and psychological features, with health impacts across the lifespan. The etiology of PCOS is complex, with an interplay of several factors, including genetic and epigenetic susceptibility, androgen exposure in early life and adiposity-related dysfunction leading to hypothalamic-ovarian disturbance.

Correction of meta-analysis after retraction of article on the effects of anti-androgens in polycystic ovary syndrome.

[This corrects the article DOI: 10.1016/j.eclinm.

Research Integrity in Guidelines and evIDence synthesis (RIGID): a framework for assessing research integrity in guideline development and evidence synthesis.

Background: Clinical guidelines rely on sound evidence to underpin recommendations for patient care. Compromised research integrity can erode public trust and the credibility of the scientific enterprise, with potential harm to patients. Despite increased recognition of integrity concerns in scientific literature, there are no processes or guidance for incorporating integrity assessments into evidence-based guideline development or evidence synthesis more broadly.

Fertility and age at childbirth in polycystic ovary syndrome: results from a longitudinal population-based cohort study.

Background: There are few studies in unselected populations describing reproductive outcomes in women with polycystic ovary syndrome (PCOS) at the end of their reproductive years.

Objective: To compare parity and maternal age at deliveries and explore factors associated with advanced maternal age in a large, unselected population-based cohort, followed prospectively for 25 years.

Study Design: Women randomly selected from the general population and included in the prospective Australian Longitudinal Study on Women's Health were assessed approximately every third year from 1996 (age 18-23 years) to 2021 (age 43-48 years).

Evaluating the diagnostic accuracy of androgen measurement in polycystic ovary syndrome: a systematic review and diagnostic meta-analysis to inform evidence-based guidelines.

Background: Biochemical hyperandrogenism is a hallmark and diagnostic feature of polycystic ovary syndrome (PCOS). However, the most accurate androgen measurement for assessing biochemical hyperandrogenism in PCOS diagnosis remains uncertain.

Objective And Rationale: This systematic review aimed to assess different androgen measures [including total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI), androstenedione (A4), dehydroepiandrosterone sulfate (DHEAS), and dihydrotestosterone (DHT)] for accuracy in diagnosing biochemical hyperandrogenism in women with PCOS, to inform the 2023 International PCOS Evidence-based Guidelines.

2023 International Evidence-Based Polycystic Ovary Syndrome Guideline Update: Insights From a Systematic Review and Meta-Analysis on Elevated Clinical Cardiovascular Disease in Polycystic Ovary Syndrome.

Background: Polycystic ovary syndrome (PCOS) is the most prevalent female endocrinopathy. Although increased cardiovascular risk factors are well established for the syndrome, PCOS remains overlooked within the realm of cardiology. We conducted a systematic review and meta-analysis on the risk of clinical cardiovascular disease (CVD) events in women with PCOS to inform the 2023 International Evidence-Based PCOS Guideline.

Increased Prevalence of Binge Eating Disorder and Bulimia Nervosa in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.

Context: Polycystic ovary syndrome (PCOS) is associated with disordered eating/eating disorders, but prior meta-analyses are limited by small numbers.

Objective: To inform the 2023 International PCOS Guideline, we performed a systematic review and meta-analysis evaluating the prevalence of disordered eating/eating disorders among women with and without PCOS.

Methods: Ovid MEDLINE, EMBASE, PsycInfo, and All EMB were searched from inception through February 1, 2024, for studies that compared prevalences of eating disordered/disordered eating in adolescent or adult women.

Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis.

Studies report interaction difficulties between patients with polycystic ovary syndrome (PCOS) and healthcare professionals (HCP). This systematic review and qualitative evidence synthesis aimed to collate and synthesize the existing peer-reviewed literature investigating challenges for people with PCOS when interacting with HCP. Medline, PsycInfo, EMBASE, All EBM and CINAHL were searched from 1990 to September 2022.

Anti-müllerian hormone as a diagnostic biomarker for polycystic ovary syndrome and polycystic ovarian morphology: a systematic review and meta-analysis.

Importance: As part of the 2023 international evidence-based polycystic ovary syndrome (PCOS) guideline, this meta-analysis investigated the inclusion of Anti-Müllerian hormone (AMH) levels in the diagnostic criteria for PCOS.

Objective: To answer the following three questions: 1) Are AMH levels effective in diagnosing PCOS in adult women? 2) Are AMH levels effective in diagnosing PCOS in adolescents? Are AMH levels effective in diagnosing polycystic ovarian morphology (PCOM)?

Data Sources: Searches were conducted in six databases until July 31, 2023.

Study Selection And Synthesis: Eligible studies were those conducted in humans, published in English, and reporting sensitivity, specificity, and/or area under the curve values.

Laser and Light-Based Therapies for Hirsutism Management in Women With Polycystic Ovarian Syndrome: A Systematic Review.

Importance: Hirsutism represents a significant concern for women with polycystic ovary syndrome (PCOS), with deleterious psychological effects warranting acknowledgment and a clear imperative to provide effective management. To our knowledge, this is the first review to exclusively examine the effectiveness of laser and light-based therapies in addressing hirsutism in women with PCOS.

Objective: To synthesize the existing literature regarding the effectiveness of laser and light hair reduction therapies, either as stand-alone treatments or in combination with systemic agents, in treating hirsutism for women with PCOS.