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The polycystic ovary syndrome: a position statement from the European Society of Endocrinology
Open accessAbstract
Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject. This paper offers a critical endocrine and European perspective on the debate on the definition of PCOS and summarises all major aspects related to aetiological factors, including early life events, potentially involved in the development of the disorder. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. We have also paid specific attention to the role of obesity, sleep disorders and neuropsychological aspects of PCOS and on the relevant pathogenetic aspects of cardiovascular risk factors. In addition, we have discussed how to target treatment choices based according to the phenotype and individual patient's needs. Finally, we have suggested potential areas of translational and clinical research for the future with specific emphasis on hormonal and metabolic aspects of PCOS.
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“Women with PCOS are often obese, develop IR and are at risk of developing T2D [187, 188].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [187]
In the citing paper
“In the diagnostic workup of PCOS, androgen excess is usually assessed by measurement of total T [187].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [187]
In the citing paper
“Hence, acquisition of total T results in women should be done by chromatography-mass spectrometry, which has become the gold standard for measurement of sex steroids [39, 187].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [187]
In the citing paper
“In contrast to total T, free T seems to be a better marker to determine hyperandrogenemia in women with PCOS [187], provided that accurate and high quality methodology is used for measured or calculated free T [193, 194].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [187]
In the citing paper
“which is associated with metabolic dysfunction (Conway et al., 2014, O'Reilly et al., 2014b).”
From Intracrine androgen biosynthesis, metabolism and action revisited (2018) · cites this paper as Conway et al., 2014
In the citing paper
“Androgen excess is recognised as the major determinant driving metabolic dysfunction observed in women with PCOS (Conway et al., 2014)”
From Intracrine androgen biosynthesis, metabolism and action revisited (2018) · cites this paper as Conway et al., 2014
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Women with Polycystic Ovary Syndrome and Risk of Cardiovascular Disease
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Self-citationSexual Function and Socio-Sexual Difficulties in Women with Polycystic Ovary Syndrome (PCOS)
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Metadata
- Authors
- Conway, G., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Franks, S., Gambineri, A., Kelestimur, F., Macut, D., Micic, D., Pasquali, R., Pfeifer, M., Pignatelli, D., Pugeat, M., & Yildiz, B. O.
- Affiliations
- University College Hospital (GB)
- National and Kapodistrian University of Athens (GR)
- Universidad Complutense de Madrid (ES)
- ORCID
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-10
- Volume
- 171
- Issue
- 4
- Pages
- P1-P29
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W1963543729
- Semantic Scholar
- 518b85a010c577bc0434b3172e959aaf7980d719
- Cited by
- 676
- References
- 288
- Citations by year
- 2026: 24 · 2025: 26 · 2024: 45 · 2023: 73 · 2022: 77 · 2021: 68 · 2020: 58 · 2019: 69 · 2018: 84 · 2017: 53 · 2016: 48 · 2015: 43 · 2014: 6
- FWCI
- 60.60
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
- 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, PCOS diagnostic criteria, PCOS phenotypes, hyperandrogenism, insulin resistance, obesity, type 2 diabetes, impaired glucose tolerance, early life events, PCOS pathogenesis, biomarkers, sleep disorders, neuropsychological aspects, cardiovascular risk factors, treatment targeting
- MeSH terms
- Androgens, Body Composition, Cardiovascular Diseases, Concept Formation, Female, Glucose, Humans, Hypoglycemic Agents, Infertility, Female, Insulin Resistance, Obesity, Ovary, Phenotype, Polycystic Ovary Syndrome, Quality of Life, Gonadal Steroid Hormones, Testosterone, Ultrasonography, Lipid Peroxidation, Biomarkers, Glucose Intolerance, Risk Reduction Behavior, Bariatric Surgery
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