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Polycystic ovary syndrome throughout a woman’s life
Open accessAbstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women and the main cause of infertility due to anovulation. However, this syndrome spans the lives of women affecting them from in-utero life until death, leading to several health risks that can impair quality of life and increase morbidity and mortality rates. Fetal programming may represent the beginning of the condition characterized by hyperandrogenism and insulin resistance which leads to a series of medical consequences in adolescence, adulthood, and old age. Menstrual and fertility problems evolve into metabolic complications as age advances. An early and precise diagnosis is important for an adequate management of PCOS, especially at the extreme ends of the reproductive lifespan. However, many different phenotypes are included under the same condition, being important to look at these different phenotypes separately, as they may require different treatments and have different consequences. In this way, PCOS exhibits a great metabolic complexity and its diagnosis needs to be revised once again and adapted to recent data obtained by new technologies. According to the current medical literature, lifestyle therapy constitutes the first step in the management, especially when excess body weight is associated. Pharmacotherapy is frequently used to treat the most predominant manifestations in each age group, such as irregular menses and hirsutism in adolescence, fertility problems in adulthood, and metabolic problems and risk of cancer in old age. Close surveillance is mandatory in each stage of life to avoid health risks which may also affect the offspring, since fetal and post-natal complications seem to be increased in PCOS women.
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“Although it can be diagnosed in adolescence, many young individuals may not know they have PCOS or do not receive a diagnosis until they experience infertility [3, 9, 24–29].”
From Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care (2023) · cites this paper as [25]
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Cited by
Sorted by citations
Recent advances in the understanding and management of polycystic ovary syndrome
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“Therefore, administration of omega-3 fatty acids should be specific only for PCOS women who already exhibit inflammatory and cardiovascular-related symptoms, which usually occur between 40 and 45 years of age [94,95].”
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“Moreover, PCOS patient’s metabolic disturbances also cause hypertension that mainly changes vascular function as caused by hyperinsulinemia (43).”
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Vitamin D and aspects of female fertility
Voulgaris, N., Papanastasiou, L., Piaditis, G. P., Angelousi, A. G., Kaltsas, G., Mastorakos, G. P., & Kassi, E. N. (2017) · HORMONES · doi:10.14310/horm.2002.1715 · Cited by 86
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Yao, S., López‐Tello, J., & Sferruzzi-Perri, A. N. (2020) · Biology of Reproduction · doi:10.1093/biolre/ioaa232 · Cited by 72
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Sangaraju, S. L., Yepez, D., Grandes, X. A., Manjunatha, R. T., & Habib, S. (2022) · Cureus · doi:10.7759/cureus.25076 · Cited by 77
“PCOS is a disorder that can affect females right from their fetal life up until their death, with several complications in between, that affect their mortality and morbidity as well as decrease their quality of life [12].”
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“” educate/train clinicians 35 [25.5] ◦ “More doctors need to know about PCOS!”
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Comparative Analysis of Lower Genital Tract Microbiome Between PCOS and Healthy Women
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“PCOS is becoming the most common cause of sterility in reproductive-aged women (Wang et al., 2015; Bellver et al., 2018; Patel, 2018).”
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The evolutionary biology of endometriosis
Dinsdale, N., Nepomnaschy, P., & Crespi, B. (2021) · Evolution, Medicine, and Public Health · doi:10.1093/emph/eoab008 · Cited by 53
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“Diagnostic overshadowing of PCOS symptoms may also impede a reliable diagnosis, and concealment and shame of disordered eating symptoms, or the health care professionals’ dearth of knowledge and skill sets in identifying and treating ED symptoms may also contribute to variable prevalence estimates.(17,59)”
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D’Alterio, M. N., Sigilli, M., Succu, A. G., GHISU, V., Laganà, A. S., Sorrentino, F., Nappi, L., Tinelli, R., & Angioni, S. L. (2021) · Minerva Obstetrics and Gynecology · doi:10.23736/s2724-606x.21.04758-4 · Cited by 50
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“Androgens are considered orexigenic, stimulating appetite, disrupting impulse control, and have been associated with binge eating behaviors in those with PCOS [66,67, 97,125,131,132].”
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Shanmugavadivel, K., S, M. D. M., Mahesh, T. R., Al‐Shehari, T., Alsadhan, N. A., & Yimer, T. E. (2024) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-024-02688-9 · Cited by 44
“Not everyone can afford to get tested or scanned [13].”
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Wang, Q., Luo, L., Lei, Q., Lin, M., Huang, X., Chen, M.-H., Zeng, Y., & Zhou, C. (2016) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2016.04.006 · Cited by 42
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Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review
XENOU, M., & Gourounti, K. (2021) · MAEDICA – a Journal of Clinical Medicine · doi:10.26574/maedica.2020.16.3.516 · Cited by 36
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Agrawal, A., Ambad, R., Lahoti, R., Muley, P. A., & Pande, P. S. (2022) · Journal of Datta Meghe Institute of Medical Sciences University · doi:10.4103/jdmimsu.jdmimsu_278_22 · Cited by 30
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Zhao, C., Zhou, Y., Shen, X., Gong, M., Lu, Y., Fang, C., Chen, J., & Ju, R. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05495-5 · Cited by 26
HOMA-IR for predicting clinical pregnancy rate during IVF
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“PCOS is a common but complex reproductive and endocrine-metabolic disorder and a primary cause of infertility among women of childbearing age [10].”
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“…phosphorylation of insulin receptors and IRS-1 secondary to intracellular serine kinases in PCOS, which results in decreased insulin-mediated activation of PI3-K and resistance to the metabolic actions of insulin has been postulated that the same kinase may inhibit insulin signaling in PCOS [29].”
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“The former include growth factors, cytokines, and inhibin in the follicular fluid, and the latter includes FSH deficiency, LH hypersecretion, high androgen levels in the ovaries and adrenal gland, IR, and hyperinsulinemia.(43,44) AMH is recognized as the primary hormonal regulator of ovarian follicular development by…”
BackgroundIncreased homozygosity due to endogamy results in fitness consequences in a human population
Swinford, N., Prall, S. P., Gopalan, S., Williams, C. M., Sheehama, J., Scelza, B. A., & Henn, B. M. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2309552120 · Cited by 26
“In addition to untreated venereal disease (45, 46), conditions such as polycystic ovarian syndrome and endometriosis can affect a woman’s ability to become pregnant (47, 48).”
Role of polyphenols in remodeling the host gut microbiota in polycystic ovary syndrome
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“Hyperandrogenemia is an essential endocrine feature of PCOS, and the andro-gen-excessive environment can inhibit follicle development and maturation, resulting in follicular atresia and decreased ovarian estradiol levels [26].”
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“4,5 6–9 Pre-eclampsia is a severe pregnancy complication with a global incidence of 3–5%.”
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“The impact of obesity and WL strategies on reproduction is especially relevant in women diagnosed with polycystic ovarian syndrome (PCOS) as their ovulatory disorders and perinatal complications are exacerbated in the presence of obesity [8, 9].”
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“PCOS is found in about 5–15% of women of reproductive age and impacts substantially upon health, fertility and well-being [11, 12].”
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Khafagy, G. M., Sayed, I. T. E., Abbas, S. M., & Soliman, S. (2020) · International Journal of Women s Health · doi:10.2147/ijwh.s279245 · Cited by 21
Polycystic Ovarian Syndrome in Adolescents
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“Regular check-ups and close surveillance are necessary for every stage of life, like adolescence, reproductive age, and old age, to reduce complications and risks that could affect the patient's offspring as it is genetically transferred [25].”
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Elpídio, L. N. S., de Alencar, J. B., Tsuneto, P. Y., Alves, H. V., Toretta, M. T., Taura, S. K. I., Visentainer, J. E. L., & Sell, A. M. (2018) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2018.08.003 · Cited by 20
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“Despite pelvic ultrasound had not been recommended for the diagnosis of PCOS before 8 years post-menarche [12, 13, 33], polycystic ovary morphology (PCOM) was defined by established criteria for adolescents and adults [7, 33, 34] using vaginal transducer with a frequency of 5–8 MHz (Toshiba Xario SSA-660A, Toshiba Med…”
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“There were four main phenotypes reported based on the Rotterdam criteria (Figure 2 ) [2,3].”
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“Introduction Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with a prevalence of between 8 and 13% depending on the population studied and definitions used [1, 2, 3].”
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“As a common type of hormonal disorder, polycystic ovary syndrome (PCOS) mainly affects women at their reproductive age [1,2].”
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Fat Mass and Obesity Association gene Polymorphism in PCOS Iraqi Women
Ibraheem, Q. A., Obaidy, L. H. A. A., Nasir, G. A., & Al‐Obaidi, M. T. (2020) · Baghdad Science Journal · doi:10.21123/bsj.2020.17.3(suppl.).1103 · Cited by 11
“In this study the age had no significant association in the PCOS because all 68 participants were in the same age, even though PCOS can affect women over wide range of their fertility life (12-55) years.”
BackgroundAlarcón-Granados, M. C., Moreno-Ortíz, H., Esteban-Pérez, C. I., Ferrebuz, A., Villalba, G. E. C., & Forero‐Castro, M. (2022) · Heliyon · doi:10.1016/j.heliyon.2022.e09673 · Cited by 12
Harnessing SIRT1 activators for effective PCOS treatment: A new frontier
Moharir, S. R., Talamadla, M. K., Bhardwaj, P., Banerjee, A., Dey, R. J., & Sekhar, K. V. G. C. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2025.118361 · Cited by 11
Inhibition of sestrin 1 alleviates polycystic ovary syndrome by decreasing autophagy
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Síndrome dos ovários policísticos: aspectos clínicos e impactos na saúde da mulher
Cavalcante, I. D. S., Mendes, I. P. G., Silva, M. L. L. D. S., Barbosa, G. S. L., Hasegawa, L. E. M., Veiga, A. V. M., Ferraz, I. C., Gomes, F. E. S., & dos Santos, L. M. D. S. A. (2021) · Research Society and Development · doi:10.33448/rsd-v10i2.12398 · Cited by 9
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“Figure 3 demonstrates the effects of PCOS at different stages of life [26].”
BackgroundMaamari, R. A., Hashmi, I. A., Dhuli, A. A. A., Abri, A. A., Ghaithi, A. A., & Sinan, S. A. (2023) · Iranian Journal of Nursing and Midwifery Research · doi:10.4103/ijnmr.ijnmr_355_22 · Cited by 9
“[5] In the Middle Eastern countries, cardiovascular diseases are already the leading cause of mortality for women.”
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“Symptoms like irregular periods and weight gain are often considered normal alterations due to stress or life-style [19, 86].”
Regenerative Medicine Perspectives in Polycystic Ovary Syndrome
Arjmand, B., Alaei, S., Heravani, N. F., Alavi-Moghadam, S., Payab, M., Ebrahimpour, M., Aghayan, H. R., Goodarzi, P., & Larijani, B. A. (2021) · Advances in experimental medicine and biology · doi:10.1007/5584_2021_623 · Cited by 8
Relation of serum vitamin D level in polycystic ovarian syndrome (PCOS) patients to ICSI outcome
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“, 2018 (6) Review -No mention about grey literature -No mention about the characteristics of the included studies -No mention of the scientific quality of the included studies 75%”
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Role of Vitamin E in Pregnancy
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Endocrine-disrupting chemicals and PCOS: A novel contributor in the etiology of the syndrome
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The Triad Of PCOS, Infertility And Metformin
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Chronic Estrus Disrupts Uterine Gland Development and Homeostasis
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Combined Oral Contraceptives for Polycystic Ovary Syndrome: Pro and Contra (Review)
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“Polycystic Ovarian Syndrome (PCOS) is one of those diseases caused by an altered lifestyle, affecting the capacity to give birth to children [1].”
BackgroundPolycystic Ovary Syndrome (PCOS)
Hechtman, L. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-43044-9.00209-0 · Cited by 6
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High androgen level causes recurrent miscarriage and impairs endometrial receptivity
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“PCOS is associated with autoimmune responses and is defined as a polygenic, multifactorial, systemic, and inflammatory disease involving imbalanced steroid levels, which suggests a connection to unhealthy lifestyle factors [ 5 ].”
Aburto-Hernández, C., Barrera, D., Ortiz-Hernández, R., Espinoza‐Simón, E., Parra-Gámez, L., González, J., Escobar, M. L., Vázquez‐Nin, G. H., Echeverría-Martínez, O., & Torres‐Ramírez, N. (2022) · Metabolites · doi:10.3390/metabo12121182 · Cited by 4
“is strongly related to metabolic diseases [25], begi n g in childhood and puberty of patients [26], we cided to analyze some metabolic parameters in 3-month-old pups.”
BackgroundRole of complementary and alternative medicine in polycystic ovary syndrome
Siddique, R., & Mehmood, M. H. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-87932-3.00031-1 · Cited by 4
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“Clinical and biochemical manifestations of PCOS change with age, 55 and obesity was related to PCOS 55 and mental health 56 both.”
Sacca, L., Okwaraji, G., Densley, S., Marciniak, A., Knecht, M. K., Wilson, C., Pilitsis, J. G., & Hopkins, D. K. (2024) · SAGE Open Medicine · doi:10.1177/20503121241262158 · Cited by 3
“45,46 Ovarian androgen secretion capacity declines with age in both healthy women and in women with PCOS; however, it remains enhanced in females and individuals with PCOS until the late reproductive years.”
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Falahati‐pour, S. K., Pourmasumi, S., & Mirhashemi, E. S. (2023) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_360_22 · Cited by 3
“Vitamin D3 and fasting blood sugar were 21.31±9.18 (ng/mL) and 97.90 ± 16.21 (mg/dL) respectively [Table 1].”
BackgroundInfluentialalhibshi, L., Sarhan, A.-M., & abdo, A. (2019) · Zagazig University Medical Journal · doi:10.21608/zumj.2019.17162.1530 · Cited by 3
Prevalencia del síndrome de ovario poliquístico en mujeres colombianas con acné en la etapa adulta
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“el 1% hasta el 45%; esto es influenciado por factores genéticos y ambientales (18).”
BackgroundNandi, A., Gillespie, S. W., Ice, S. N., Thakur, D., Gaur, Y. K., Singh, K. D., & Sharma, K. (2025) · Biosensors and Bioelectronics X · doi:10.1016/j.biosx.2025.100657 · Cited by 2
Metadata
- Authors
- Group of interest in Reproductive Endocrinology (GIER) of the Spanish Fertility Society (SEF), Bellver, J., Rodríguez-Tabernero, L., Robles, A., Muñoz, E., Martínez, F., Landeras, J., García-Velasco, J., Fontes, J., Álvarez, M., Álvarez, C., & Acevedo, B.
- Affiliations
- Universitat de València (ES)
- Hospital Del Mar (ES)
- Hospital Universitario Dexeus (ES)
- Universidad Rey Juan Carlos (ES)
- Hospital Universitario Virgen de las Nieves (ES)
- Hospital Universitario Fundación Jiménez Díaz (ES)
- Corresponding author
- Bellver, José
- Venue
- Journal of Assisted Reproduction and Genetics
- Published
- 2017-09-27
- Volume
- 35
- Issue
- 1
- Pages
- 25-39
- ISSN
- 0740-7769 (ISSN-L)
- 1058-0468
- 1573-7330
- PMC
- PMC5758469
- OpenAlex
- W2758457511
- Cited by
- 180
- References
- 146
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 20 · 2023: 28 · 2022: 25 · 2021: 35 · 2020: 22 · 2019: 13 · 2018: 9 · 2017: 1
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Assisted Reproduction and Genetics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, PCOS phenotypes, fetal programming, hyperandrogenism, insulin resistance, anovulation, infertility, PCOS diagnosis, lifestyle therapy, pharmacotherapy
- MeSH terms
- Adolescent, Adult, Female, Humans, Middle Aged, Polycystic Ovary Syndrome, Reproduction, Sexual Maturation, Growth and Development, Young Adult
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