Cited by 676Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsEndometriosis Research and Treatment

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The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

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Conway, Gerard, Dewailly, Didier, Diamanti-Kandarakis, Evanthia, Escobar-Morreale, Héctor F, Franks, Stephen, Gambineri, Alessandra, Kelestimur, Fahrettin, Macut, Djuro, Micic, Dragan, Pasquali, Renato, Pfeifer, Marija, Pignatelli, Duarte, Pugeat, Michel, Yildiz, Bulent O·2014·European Journal of Endocrinology

DOI 10.1530/eje-14-0253

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Abstract

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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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: Conway, Gerard
Dewailly, Didier
Escobar-Morreale, Héctor F
Gambineri, Alessandra
Pignatelli, Duarte
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
DOI: 10.1530/eje-14-0253
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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