Polycystic ovary syndrome. Revised diagnostic criteria and long-term health consequences

Kousta, Eleni; Tolis, George; Franks, Stephen

doi:10.14310/horm.2002.11151

Cited by 35Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsEndometriosis Research and Treatment

Polycystic ovary syndrome. Revised diagnostic criteria and long-term health consequences

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Kousta, Eleni, Tolis, George, Franks, Stephen·2005·HORMONES

DOI 10.14310/horm.2002.11151

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Abstract

The diagnostic criteria for polycystic ovary syndrome (PCOS) have recently been revised. The polycystic ovarian morphology has been introduced as part of the criteria and an international consensus has been achieved providing the basis for future research and collaboration. It is now accepted that polycystic ovary syndrome has important long-term health implications, including metabolic disorders and increased risk factors for cardiovascular disease. The overall risk of developing type 2 diabetes among women with PCOS was found to be increased 3-7 times. Women with PCOS have increased levels of cardiovascular risk factors: insulin resistance, obesity, dyslipidaemia, hypertension and markers of abnormal vascular function. However, the level of risk for cardiovascular disease remains uncertain. The limited epidemiological data available to date have shown no increase in cardiovascular events although the incidence of cerebrovascular events was increased. The evidence for an increased risk for endometrial carcinoma among women with PCOS is limited. Long-term epidemiological studies of women with well defined PCOS are needed in order to assess the risk of long-term health consequences, to identify the subgroups among PCOS women who need to be targeted and to determine the timing and nature of measures for intervention and prevention.

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Dyslipidaemia is associated with insulin resistance in women with polycystic ovaries
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Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity
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Postprandial thermogenesis is reduced in polycystic ovary syndrome and is associated with increased insulin resistance
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Lack of association of C-reactive protein and coronary calcium by electron beam computed tomography in postmenopausal women: implications for coronary artery disease screening
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The prevalence of polycystic ovaries in women with a history of gestational diabetes
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Metabolic approaches to the subclassification of polycystic ovary syndrome
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Increased Endothelin-1 Levels in Women with Polycystic Ovary Syndrome and the Beneficial Effect of Metformin Therapy
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The Potential for Lifestyle Change to Influence the Progression of Impaired Glucose Tolerance to Non-insulin-dependent Diabetes Mellitus
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Association of Hyperandrogenemic and Metabolic Phenotype with Carotid Intima-Media Thickness in Young Women with Polycystic Ovary Syndrome
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[6]6. Zawadzki JK, Dunaif A 1992 Diagnostic criteria for polycystic ovary syndrome: towards a rational approach In: Dunaif A, Givens JR, Haseltine FR, Merriam GR (eds) Polycystic ovary syndrome, Oxford, England: Blackwell Scientific; pp, 377-384.
[22]22. Abbott DH, Dumesic DA, Franks S, 2002 Develop- mental origin of polycystic ovary syndrome -a hypo- thesis. J Endocrinol 174: 1-5.

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Searching for polycystic ovary syndrome in postmenopausal women
Krentz, A. J., von Mühlen, D. G., & Barrett-Connor, E. L. (2007) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e31802cc7ab · Cited by 108 · see citing works
Systematic screening for metabolic syndrome in consumers with severe mental illness
Brunero, S., & Lamont, S. (2009) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2009.00595.x · Cited by 72 · see citing works
Polycystic Ovary Syndrome: An Updated Overview Foregrounding Impacts of Ethnicities and Geographic Variations
Yasmin, A., Roychoudhury, S., Choudhury, A. P., Ahmed, A. B. F., Dutta, S., Mottola, F., Verma, V., Kalita, J. C., Kumar, D., Sengupta, P., et al. (2022) · Life · doi:10.3390/life12121974 · Cited by 73 · see citing works
Reproductive Health as a Sentinel of Chronic Disease in Women
Rich-Edwards, J. W. (2009) · Women s Health · doi:10.2217/17455057.5.2.101 · Cited by 50 · see citing works
Evaluation of Fenugreek (Trigonella foenum-graceum L.), Effects Seeds Extract on Insulin Resistance in Women with Polycystic Ovarian Syndrome.
Bashtian, M. H., Emami, S. A., Mousavifar, N., Esmaily, H. A., Mahmoudi, M., & Poor, A. H. M. (2013) · Europe PMC (PubMed Central) · Cited by 44 · see citing works
Early microvascular and macrovascular dysfunction is not accompanied by structural arterial injury in polycystic ovary syndrome
Alexandraki, K., Protogerou, A. D., Papaioannou, T., Piperi, C., Mastorakos, G. P., Lekakis, J. P., Panidis, D., & Diamanti‐Kandarakis, E. (2006) · HORMONES · doi:10.14310/horm.2002.11176 · Cited by 43 · see citing works
Long-term treatment with dehydroepiandrosterone may lead to follicular atresia through interaction with anti-Mullerian hormone
Ikeda, K., Baba, T., 森下, 美., Honnma, H., Endo, T., Kiya, T., & Saito, T. (2014) · Journal of Ovarian Research · doi:10.1186/1757-2215-7-46 · Cited by 37 · see citing works
“Background Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic dysfunction in women of reproductive age, and a frequent cause of anovulatory infertility and hyperandrogenism [1].”
Background
Insulin response to oral glucose in healthy, lean young women and patients with polycystic ovary syndrome
Kulshreshtha, B., Ganie, M. A., Praveen, E. P., Gupta, N., Khurana, M. L., Seith, A., Dwivedi, S. N., Kumar, G., & Ammini, A. C. (2008) · Gynecological Endocrinology · doi:10.1080/09513590802342858 · Cited by 35 · see citing works
Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients
Shi, S., Hong, T., Jiang, F., Zhuang, Y., Chen, L., & Huang, X. (2020) · Medicine · doi:10.1097/md.0000000000018383 · Cited by 26 · see citing works
“The diagnosis of PCOS based on the revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.([7,8]) At least two of the following three were met:”
Method
Elevated coagulation and inflammatory markers in adolescents with a history of premature adrenarche
Livadas, S., Dracopoulou, M., Vasileiadi, K., Lazaropoulou, C., Magiakou, M. A., Xekouki, P., Voutetakis, A., Kanaka‐Gantenbein, C., Papassotiriou, I., Stefanadis, C., et al. (2009) · Metabolism · doi:10.1016/j.metabol.2008.12.002 · Cited by 23 · see citing works
Decreased lipin 1β expression in visceral adipose tissue is associated with insulin resistance in polycystic ovary syndrome
Mlinar, B., Pfeifer, M., Bokal, E. V., Jensterle, M., & Marc, J. (2008) · European Journal of Endocrinology · doi:10.1530/eje-08-0387 · Cited by 23 · see citing works
Evaluation of Adolescents for Polycystic Ovary Syndrome in an Urban Population - Original Article
Broder‐Fingert, S., Shah, B. C., Kessler, M., Pawelczak, M., & DAVID, R. R. (2009) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.v1i4.50 · Cited by 20 · see citing works
Early onset adiposity: a pathway to polycystic ovary syndrome in adolescents?
Diamanti‐Kandarakis, E., Christakou, C. D., Kandaraki, E., & Alexandraki, K. (2007) · PubMed · Cited by 20 · see citing works
Expression of 11β-hydroxysteroid dehydrogenase type 1 in visceral and subcutaneous adipose tissues of patients with polycystic ovary syndrome is associated with adiposity
Mlinar, B., Marc, J., Jensterle, M., Bokal, E. V., Jerin, A., & Pfeifer, M. (2010) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2010.12.002 · Cited by 20 · see citing works
Lipid Profile Changes Induced by Chronic Administration of Anabolic Androgenic Steroids and Taurine in Rats
Roşca, A. E., Stancu, C. S., Badiu, C., Popescu, B. O., Mirică, R., Căruntu, C., Gologan, S., Voiculescu, S. E., & Zăgrean, A. (2019) · Medicina · doi:10.3390/medicina55090540 · Cited by 18 · see citing works
The association between the Mediterranean Diet and the Prime Diet Quality Score and polycystic ovary syndrome: a case control study
Ajorlouie, Z., Moshkian, P., Baghdadi, G., Amiri, R., Biglari, F., & Rahimlou, M. (2025) · BMC Nutrition · doi:10.1186/s40795-025-01067-5 · Cited by 17 · see citing works
“PCOS is diagnosed based on the Rotterdam criteria [2], which require the presence of at least two of the following three features: hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, after excluding other causes of hyperandrogenism [3, 4].”
Comparison of Finasteride, Metformin, and Finasteride Plus Metformin in PCOS
Diri, H. (2017) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2017.84 · Cited by 14 · see citing works
“Features associated with PCOS include physical attributes of hyperandrogenism, such as hirsutism, acne, deepening of the voice, and male pattern baldness; as well as various disorders, such as ovulatory dysfunction, infertility, endometrial hyperplasia, endometrial cancer, mood disorders, obstructive sleep apnea, obes…”
Background
Association of serum pigment epithelium-derived factor with high-sensitivity C-reactive protein in women with polycystic ovary syndrome
Cheng, Q., Xia, W., Yang, S., Ye, P., Mei, M., Song, Y., Luo, M., & Li, Q. (2013) · Journal of Endocrinological Investigation · doi:10.1007/bf03346755 · Cited by 14 · see citing works
Assessment of symptoms of urinary incontinence in women with polycystic ovary syndrome
Montezuma, T., Antônio, F. I., Silva, A. C. J. D. S. R. E., de Sá, M. F. S., Ferriani, R. A., & Ferreira, C. H. J. (2011) · Clinics · doi:10.1590/s1807-59322011001100010 · Cited by 14 · see citing works
RETRACTED: Endothelial function in young women with polycystic ovary syndrome (PCOS): Implications of body mass index (BMI) and insulin resistance
El-Kannishy, G. M., Kamal, S., Mousa, A. A., Saleh, O., Badrawy, A. E., El-Farahaty, R. M., & Shokeir, T. A. (2009) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2009.08.001 · Cited by 13 · see citing works
Retracted
Inflammatory Response Patterns in ICSI Patients: A Comparative Study Between Chronic Anovulating and Normally Ovulating Women
Lamaita, R. M., Pontes, A., Belo, A. V., Caetano, J. P. J., Andrade, S. P., Cândido, E. B., Traiman, P., Carneiro, M. M., & Filho, A. L. D. S. (2012) · Reproductive Sciences · doi:10.1177/1933719111428518 · Cited by 13 · see citing works
Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women
Tang, L., Xu, L., Pan, X., Zhang, J., Wu, T., & Liu, G. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008583 · Cited by 12 · see citing works
A Review on: Polycystic Ovarian Disorder
Devade, O. A., Londhe, R. D., Sokate, N. V., Randave, U. R., & Ranpise, P. A. (2022) · Asian Journal of Research in Pharmaceutical Sciences · doi:10.52711/2231-5659.2022.00039 · Cited by 7 · see citing works
Diagnostic difficulties of polycystic ovarian syndrome in adolescent girls
Ságodi, L., & Barkai, L. (2013) · Orvosi Hetilap · doi:10.1556/oh.2013.29527 · Cited by 6 · see citing works
Cardiopulmonary functional capacity and the role of exercise in improving maximal oxygen consumption in women with PCOS.
Lenarcik, A., & Bidzińska−Speichert, B. (2010) · PubMed · Cited by 4 · see citing works
Polycystic ovarian syndrome and its potential association with bipolar disorder in patients with eating disorder
Guarín, M. R., Rueda, J. G., Muñoz, V. P., & Salazar, O. R. (2017) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.1016/j.rmta.2016.12.003 · Cited by 4 · see citing works
“…asociado a sobrepeso u obesidad también es más frecuente en mujeres con SOP (Azziz et al., 2004; El Hayek, Bitar, Hamdar, Mirza y Daoud, 2016; Goodarzi, Dumesic, Chazenbalk y Azziz, 2011; Hussain et al., 2015; Kousta, Tolis y Franks, 2005; Kyrou, Weickert y Randeva, 2015; Sirmans y Pate, 2014).”
Background
Diagnosis, Pathogenesis and Management of Polycystic Ovary Syndrome
Wang, F., & Wang, Z. (2017) · InTech eBooks · doi:10.5772/67877 · Cited by 4 · see citing works
“PCOS not only can affect the female reproductive function, but also increase the incidence risk of tumors such as endometrial cancer, type 2 diabetes and cardiovascular disease [6].”
Background
Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study
Geronikolou, S. A., Bacopoulou, F., Chryssanthopoulos, S., Cokkinos, D. V., & Chrousos, G. P. (2022) · Children · doi:10.3390/children9030316 · Cited by 3 · see citing works
“In addition, the syndrome has adverse cardiovascular implications [5], clinical manifestations of systemic “para-inflammation” and disorderly sleep [6], hypertension [7,8], dermatological manifestations [9], and anxiety and/or depression [10].”
Background
Segundo Consenso Argentino sobre patologías endocrinológicas
Pusiol, E. (2007) · Revista Argentina de Endocrinología y Metabolismo · Cited by 2 · see citing works
Serum Uric Acid Concentration in Overweight and Obese Women with Polycystic Ovary Syndrome / Nivelul acidului uric la femeile supraponderale și obeze cu sindromul ovarelor polichistice
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“Thus, PCOS can be considered a variant of the metabolic syndrome (6).”
Background
Endogenous Sex Hormones and Risk of Type 2 Diabetes Mellitus in Men and Women
Golden, S. H. (2010) · Principles of Gender-Specific Medicine · doi:10.1016/b978-0-12-374271-1.00056-3 · Cited by 1 · see citing works
Serum Cortisol in: 1.women with polycystic ovary syndrome 2.women with premature ovarian failure
Al-Chalabi, S. (2013) · Cited by 1 · see citing works
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Recent Advancement in Biological Sciences
(2021) · Lincoln Research and Publications Limited, Australia in Collaboration with Lincoln University College, Malaysia eBooks · doi:10.31674/book.2021.rabs
PCOS Detection in Ultrasound Images Using Transfer Learning and Data Augmentation: An Explainable AI Approach with Grad-CAM
Kumari, H. M. L. S., & Walgampaya, C. (2025) · SLAAI International Conference on Artificial Intelligence (SLAAI-ICAI) · doi:10.1109/slaai-icai68534.2025.11318488

Long-term health consequences of polycystic ovary syndrome
Κousta, E., & Franks, S. (2001) · Cambridge University Press eBooks · doi:10.1017/cbo9780511545191.007 · Cited by 11 · see citing works
Self-citation
Long-term health risks of polycystic ovary syndrome
Dewailly, D. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9781107478343.009
Long‐term health outcomes in young women with polycystic ovary syndrome: A narrative review
Allen, L. A., Shrikrishnapalasuriyar, N., & Rees, A. (2021) · Clinical Endocrinology · doi:10.1111/cen.14609 · Cited by 73 · see citing works
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Authors: Kousta, E., Tolis, G., & Franks, S.
Affiliations: Hammersmith Hospital (GB)
ORCID: Franks, Stephen
Venue: HORMONES
Publisher: Springer Science and Business Media LLC
Published: 2005-07-15
Volume: 4
Issue: 3
Pages: 133-147
ISSN: 1109-3099 (ISSN-L)
DOI: 10.14310/horm.2002.11151
OpenAlex: W1989025413
Cited by: 35
References: 136
Citations by year: 2025: 2 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 1 · 2017: 3 · 2015: 1 · 2014: 1 · 2013: 4 · 2012: 1
FWCI: 0.38
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: HORMONES (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Keywords: polycystic ovary syndrome, diagnostic criteria, polycystic ovary morphology, long-term health effects, type 2 diabetes risk, cardiovascular risk factors, insulin resistance, obesity, dyslipidemia, hypertension, vascular function, cerebrovascular events, endometrial cancer
MeSH terms: Adolescent, Adult, Biopsy, Needle, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, United Kingdom, Health Status, Humans, Hyperinsulinism, Insulin Resistance, Middle Aged, Obesity, Polycystic Ovary Syndrome, Prognosis, Quality of Life, Severity of Illness Index, Prevalence, Disease Progression, Risk Assessment, Ultrasonography, Doppler

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Polycystic ovary syndrome. Revised diagnostic criteria and long-term health consequences

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