Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017
Open accessAbstract
STUDY QUESTION: What is the current burden of polycystic ovary syndrome (PCOS) at the global, regional, and country-specific levels in 194 countries and territories according to age and socio-demographic index (SDI)? SUMMARY ANSWER: Slight increases in age-standardized incidence of PCOS and associated disability-adjusted life-years (DALYs) were evidenced among women of reproductive age (15-49 years) from 2007 to 2017 at the global level, and in most regions and countries. WHAT IS KNOWN ALREADY: No detailed quantitative estimates of the PCOS incidence and DALYs by age and SDI in these 194 countries and territories have been published previously. STUDY DESIGN, SIZE, DURATION: An age- and SDI-stratified systematic analysis of the PCOS incidence and DALYs across 194 countries and territories has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: We used data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2017 to estimate the total and age-standard PCOS incidence rates and DALYs rates among women of reproductive age in both 2007 and 2017, and the trends in these parameters from 2007 to 2017. MAIN RESULTS AND THE ROLE OF CHANCE: Globally, women of reproductive age accounted for 1.55 million (95% uncertainty intervals (UIs): 1.19-2.08) incident cases of PCOS and 0.43 million (0.19-0.82) associated DALYs. The global age-standardized PCOS incidence rate among women of reproductive age increased to 82.44 (64.65-100.24) per 100 000 population in 2017, representing an increase of 1.45% (1.43-1.47%) from 2007 to 2017. The rate of age-standardized DALYs increased to 21.96 (12.78-31.15) per 100 000 population in 2017, representing an increase of 1.91% (1.89-1.93%) from 2007 to 2017. Over the study period, the greatest increase in the age-standardized PCOS incidence and DALYs rates were observed in the middle-SDI and high-middle SDI regions, respectively. At the GBD regional level, the highest age-standardized incidence and DALY rates in 2017 were observed in Andean Latin America, whereas the largest percentage increases in both rates from 2007 to 2017 were observed in Tropical Latin America. At the national level, Ecuador, Peru, Bolivia, Japan, and Bermuda had the highest age-standardized incidence rates and DALYs rates in both 2007 and 2017. The highest increases in both the age-standardized incidence rates and DALYs rates from 2007 to 2017 were observed in Ethiopia, Brazil, and China. LIMITATIONS, REASONS FOR CAUTION: Although the GBD (2017) study aimed to gather all published and unpublished data, the limited availability of data in some regions might have led to the estimation of wide UIs. Additionally, the PCOS phenotype is complicated and the diagnostic criteria are constantly changing. Consequently, the incidence of PCOS might have been underestimated. WIDER IMPLICATIONS OF THE FINDINGS: Knowledge about the differences in the PCOS burden across various locations will be valuable for the allocation of resources and formulation of effective preventive strategies. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by grants from the Innovative Talent Support Plan of the Medical and Health Technology Project in Zhejiang Province (2021422878), Ningbo Science and Technology Project (202002N3152), Ningbo Health Branding Subject Fund (PPXK2018-02), Sanming Project of Medicine in Shen-zhen (SZSM201803080), and National Social Science Foundation (19AZD013). No potential conflicts of interest relevant to this article were reported. TRIAL REGISTRATION NUMBER: N/A.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32279-7 · Cited by 13,867 · see citing works
Self-citationVos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32154-2 · Cited by 13,220 · see citing works
Self-citation(2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.004 · Cited by 9,050 · see citing works
Kyu, H. H., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32335-3 · Cited by 4,112 · see citing works
The Diagnosis of Polycystic Ovary Syndrome during Adolescence
Witchel, S. F., Oberfield, S., Rosenfield, R. L., Codner, E., Bonny, A., Ibáñez, L., Pena, A., Horikawa, R., Gomez-Lobo, V., Joel, D., et al. (2015) · Hormone Research in Paediatrics · doi:10.1159/000375530 · Cited by 3,113 · see citing works
Men at risk: occupation and male infertility.
Claman, P. (2004) · Fertility and Sterility · doi:10.1016/s0015-0282(03)01188-9 · Cited by 2,219 · see citing works
Polycystic Ovary Syndrome: Definition, Aetiology, Diagnosis and Treatment
Escobar-Morreale, H. F. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2018.24 · Cited by 2,083 · see citing works
Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2350 · Cited by 1,919 · see citing works
Teede, H. J., Misso, M. L., Costello, M. F., Dokras, A., Laven, J., Moran, L., Piltonen, T., Norman, R. J., & the International PCOS Network (2018) · Clinical Endocrinology · doi:10.1111/cen.13795 · Cited by 1,823 · see citing works
March, W. A., Moore, V. M., Willson, K. J., Phillips, D. I. W., Norman, R. J., & Davies, M. J. (2010) · Human Reproduction · doi:10.1093/humrep/dep399 · Cited by 1,799 · see citing works
Teede, H. J., Misso, M. L., Costello, M. F., Dokras, A., Laven, J., Moran, L., Piltonen, T., Norman, R. J., International PCOS Network, Andersen, M., et al. (2018) · Human Reproduction · doi:10.1093/humrep/dey256 · Cited by 1,593 · see citing works
Lim, S. S., Davies, M. J., Norman, R. J., & Moran, L. J. (2012) · Human Reproduction Update · doi:10.1093/humupd/dms030 · Cited by 939 · see citing works
Balen, A. H., Morley, L. C., Misso, M., Franks, S., Legro, R. S., Wijeyaratne, C. N., Stener-Victorin, E., Fauser, B. C. J. M., Norman, R. J., & Teede, H. (2016) · Human Reproduction Update · doi:10.1093/humupd/dmw025 · Cited by 705 · see citing works
Yildiz, B. O., Bozdag, G., Yapici, Z., Esinler, I., & Yarali, H. (2012) · Human Reproduction · doi:10.1093/humrep/des232 · Cited by 704 · see citing works
Sun, H. J., Gong, T., Jiang, Y., Zhang, S., Zhao, Y., & Wu, Q. (2019) · Aging · doi:10.18632/aging.102497 · Cited by 657 · see citing works
Self-citationUltra-Processed Food Products and Obesity in Brazilian Households (2008–2009)
Canella, D. S., Levy, R. B., Martins, A. P. B., Claro, R. M., Moubarac, J.-C., Baraldi, L. G., Cannon, G., & Monteiro, C. A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0092752 · Cited by 535 · see citing works
EHRMAN, D. A., Barnes, R. B., & Rosenfield, R. L. (1995) · Endocrine Reviews · doi:10.1210/edrv-16-3-322 · Cited by 502 · see citing works
Yadgir, S., Johnson, C. O., Aboyans, V., Adebayo, O., Adedoyin, R. A., Afarideh, M., Alahdab, F., Alashi, A., Alipour, V., Arabloo, J., et al. (2020) · Circulation · doi:10.1161/circulationaha.119.043391 · Cited by 496 · see citing works
Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity
Wolf, W. M., Wattick, R. A., Kinkade, O. N., & Olfert, M. D. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15112589 · Cited by 415 · see citing works
Ehrmann, D. A. (1995) · Endocrine Reviews · doi:10.1210/er.16.3.322 · Cited by 403 · see citing works
Ding, T., Hardiman, P. J., Petersen, I., Wang, F.-F., Qu, F., & Baio, G. (2017) · Oncotarget · doi:10.18632/oncotarget.19180 · Cited by 336 · see citing works
Adolescent polycystic ovary syndrome according to the international evidence-based guideline
Peña, A. S., Witchel, S. F., Hoeger, K. M., Oberfield, S. E., Vogiatzi, M. G., Misso, M. L., Garad, R. M., Dabadghao, P., & Teede, H. J. (2020) · BMC Medicine · doi:10.1186/s12916-020-01516-x · Cited by 331 · see citing works
James, S. L., Lucchesi, L. R., Bisignano, C., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Henry, N. J., McCracken, D., Roberts, N. L. S., et al. (2019) · Injury Prevention · doi:10.1136/injuryprev-2019-043299 · Cited by 211 · see citing works
Healthy China 2030: moving from blueprint to action with a new focus on public health
Chen, P., Li, F., & Harmer, P. (2019) · The Lancet Public Health · doi:10.1016/s2468-2667(19)30160-4 · Cited by 198 · see citing works
Association between polycystic ovary syndrome and female-to-male transsexuality
Baba, T., Endo, T., Honnma, H., Kitajima, Y., Hayashi, T., Ikeda, H., Masumori, N., Kamiya, H., Moriwaka, O., & Saito, T. (2006) · Human Reproduction · doi:10.1093/humrep/del474 · Cited by 132 · see citing works
Witchel, S. F., Teede, H. J., & Peña, A. S. (2019) · Pediatric Research · doi:10.1038/s41390-019-0615-1 · Cited by 129 · see citing works
The diagnosis and treatment of PCOS in adolescents: an update
Witchel, S. F., Burghard, A. C., Tao, R., & Oberfield, S. E. (2019) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000000778 · Cited by 128 · see citing works
The implication of the shortage of health workforce specialist on universal health coverage in Kenya
Mumbo, H. M., Were, S. O., Murianki, C. A., Mutuku, M. P., & Mutwiwa, S. N. (2017) · Human Resources for Health · doi:10.1186/s12960-017-0253-9 · Cited by 126 · see citing works
Azziz, R. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.05.009 · Cited by 121 · see citing works
Wild, R. A. (2012) · Steroids · doi:10.1016/j.steroids.2011.12.002 · Cited by 117 · see citing works
Conway, G., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Franks, S., Gambineri, A., Kelestimur, F., Macut, D., Micic, D., Pasquali, R., et al. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0252 · Cited by 113 · see citing works
Desempenho da Atenção Primária à Saúde segundo o instrumento PCATool: uma revisão sistemática
Prates, M. L., Machado, J. C., da Silva, L. S., et al. (2017) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232017226.14282016 · Cited by 86 · see citing works
Long term complications of polycystic ovary syndrome (PCOS)
Peigné, M., & Dewailly, D. (2014) · Annales d Endocrinologie · doi:10.1016/j.ando.2014.07.111 · Cited by 81 · see citing works
Futterweit, W. (1999) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199906000-00024 · Cited by 76 · see citing works
Baba, T., Endo, T., Ikeda, K., Shimizu, A., Honnma, H., Ikeda, H., Masumori, N., Ohmura, T., Kiya, T., Fujimoto, T., et al. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02252.x · Cited by 67 · see citing works
Damtew, Z. A., Karim, A. M., Chekagn, C. T., Zemichael, N. F., Yihun, B. Y., Willey, B., & Betemariam, W. A. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-1975-y · Cited by 63 · see citing works
The Utilization of Home Care by the Elderly in Brazil's Primary Health Care System
Thumé, E., Facchini, L. A., Wyshak, G., & Campbell, P. H. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.184648 · Cited by 61 · see citing works
Naal, H., Koussa, M. E., Hamouch, M. E., Hneiny, L., & Saleh, S. S. (2020) · Globalization and Health · doi:10.1186/s12992-020-00585-0 · Cited by 58 · see citing works
Apter, D. (1998) · Trends in Endocrinology & Metabolism · doi:10.1016/s1043-2760(98)00020-4 · Cited by 56 · see citing works
Rieger, M., Wagner, N., Mebratie, A. D., Alemu, G., & Bedi, A. S. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.05.037 · Cited by 48 · see citing works
Fix, J., Annesi‐Maesano, I., Baldi, I., Boulanger, M., Cheng, S., Cortés, S., Dalphin, J., Dalvie, M. A., Degano, B., Douwes, J. E., et al. (2020) · Journal of Agromedicine · doi:10.1080/1059924x.2020.1713274 · Cited by 25 · see citing works
Influência do excesso de peso e da obesidade nos gastos em saúde nos domicílios brasileiros
Canella, D. S., Novaes, H. M. D., & Levy, R. B. (2015) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00184214 · Cited by 20 · see citing works
Chima, S. C., & Mamdoo, F. (2015) · Nigerian Journal of Clinical Practice · doi:10.4103/1119-3077.170820 · Cited by 19 · see citing works
Prevalence of polycystic ovary syndrome in a metabolically healthy obese population
Mu, L., Zhao, Y., Li, R., Lai, Y., Chang, H.-M., & Qiao, J. (2019) · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · doi:10.1002/ijgo.12824 · Cited by 18 · see citing works
Endocrine characteristics of polycystic ovary syndrome (PCOS).
Szilágyi, A., & Szabó, I. (2003) · PubMed · Cited by 12 · see citing works
[Adverse events of psychotropic drugs].
Watanabe, K., & Kikuchi, T. (2014) · PubMed · Cited by 8 · see citing works
Roldós, M. I., Hopenhayn, C., Sacoto, F., et al. (2017) · Journal of Public Health Policy · doi:10.1057/s41271-017-0069-9 · Cited by 8 · see citing works
Johnson, C. M., Molina, Y., Blas, M. M., Erickson, M., Bayer, A. M., Chiappe, M., Nevin, P. E., Alva, I. E., & Rao, D. (2018) · Health Care For Women International · doi:10.1080/07399332.2017.1421198 · Cited by 8 · see citing works
[Towards an effective assessment of the sustainability of health interventions].
Capone, A. (2019) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Guang Z. Principles of Epidemiology: Application in Public Health Practice. China: Peking Union Medical College Press, 2009.
- Wang M. Program for the Development of Chinese Women (2001-2010) brief introduction. China Primary Health Care 2001; 15: 9– 10.
Cited by
Sorted by citations
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485 · see citing works
Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics
Singh, S., Pal, N., Shubham, S., Sarma, D. K., Verma, V., Marotta, F., & Kumar, M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12041454 · Cited by 521 · see citing works
Yadav, S., Delau, O., Bonner, A. J., Markovic, D., Patterson, W., Ottey, S., Buyalos, R. P., & Azziz, R. (2023) · eLife · doi:10.7554/elife.85338 · Cited by 85 · see citing works
Meng, Y., Zhao, T., Zhang, R., Zhu, X., Ma, C., & Shi, Q. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1514250 · Cited by 43 · see citing works
Top 100 #PCOS influencers: understanding who, why and how online content for PCOS is influenced
Elhariry, M., Malhotra, K., Solomon, M., Goyal, K., & Kempegowda, P. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1084047 · Cited by 21 · see citing works
Polycystic Ovary Syndrome and the Internet of Things: A Scoping Review
Graca, S., Alloh, F., Lagojda, L., Dallaway, A., Kyrou, I., Randeva, H. S., & Kite, C. (2024) · Healthcare · doi:10.3390/healthcare12161671 · Cited by 14 · see citing works
“The global prevalence of PCOS has increased in the past decades [4], with an estimated prevalence of 11–13% worldwide [5], and a significant related economic burden on healthcare systems.”
BackgroundMalhotra, N., Arora, T., Suri, V., Jena, S. K., Verma, A., Gowri, M., Kapoor, N., Chalga, M. S., Kulkarni, B., & Kamath, M. S. (2023) · Trials · doi:10.1186/s13063-023-07466-y · Cited by 10 · see citing works
Afaq, M., Vashisht, K., Al-Dhoon, A., Abraham, D., Atanasov, A. G., Matin, M., Arshad, Z., Kashyap, R., & Nawaz, F. A. (2025) · DIGITAL HEALTH · doi:10.1177/20552076251314100 · Cited by 6 · see citing works
- Authors
- Liu, J., Wu, Q., Hao, Y., Jiao, M., Wang, X., Jiang, S., & Han, L.
- Affiliations
- Harbin Medical University (CN)
- Ningbo No. 2 Hospital (CN)
- Corresponding author
- Wu, Qunhong
- Han, Liyuan
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-01-27
- Volume
- 36
- Issue
- 4
- Pages
- 1108-1119
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- PMC
- PMC7970729
- OpenAlex
- W3123495665
- Cited by
- 203
- References
- 49
- Citations by year
- 2026: 23 · 2025: 54 · 2024: 47 · 2023: 39 · 2022: 34 · 2021: 6
- FWCI
- 17.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Human Reproduction (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Innovative Talent Support Plan of the Medical and Health Technology Project in Zhejiang Province (2021422878)
- Ningbo Science and Technology Project (202002N3152)
- Ningbo Health Branding Subject Fund (PPXK2018-02)
- Sanming Project of Medicine in Shen-zhen (SZSM201803080)
- National Social Science Foundation (19AZD013)
- Ningbo Science and Technology (202002N3152)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › scientometrics and bibliometrics research
- Keywords
- polycystic ovary syndrome, disease burden, incidence, disability-adjusted life years, women of reproductive age, socio-demographic index, age-standardized rates, temporal trends, global health burden, reproductive health, Global Burden of Disease Study 2017, low- and middle-income countries, high-income countries, regional variation, country-level variation
- MeSH terms
- Global Burden of Disease, Adolescent, Adult, Brazil, China, Female, Humans, Japan, Middle Aged, Polycystic Ovary Syndrome, Global Health, Incidence, Quality-Adjusted Life Years, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
