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Diagnostic Criteria and Epidemiology of PCOS

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Abstract

Polycystic ovary syndrome (PCOS) is considered as the most common endocrine disorder amongst reproductive-age women. While characterized by a chronic course, and features that suggest varying combinations of reproductive functional deficits (such as ovulatory dysfunction or polycystic ovarian morphology) and androgen excess (such as acne, and hirsutism), the diagnosis of PCOS is based on well-defined criteria. Ethnicity, lifestyle, and certain underlying secondary disorders can impact on diagnostic accuracy of the disorder. There are currently three major sets of diagnostic criteria for the polycystic ovary syndrome (PCOS), with slight variations between them. The prevalence of PCOS varies depending on the diagnostic criteria utilized as well as the region and ethnicity studied. The prevalence of PCOS is high among women with resistant acne and hirsutism, so patients presenting with these findings should be screened for menstrual irregularities. A timely diagnosis of this chronic disorder allows an opportunity for early detection of a spectrum of morbidities that are commonly encountered in women with PCOS (such as metabolic syndrome, impaired glucose tolerance, type 2 diabetes mellitus, dyslipidemia and depression), and will allow for timely institution of preventive strategies aimed at minimizing the overall health risk in this population.

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References

  1. Stein I, Leventhal M. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181–5.

    Google Scholar 

  2. Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, editors. Polycystic ovary syndrome. Boston, MA: Blackwell Scientific Publications; 1992. p. 377–84.

    Google Scholar 

  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.

    Article  Google Scholar 

  4. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91(2):456–88.

    Article  PubMed  Google Scholar 

  5. Eilertsen TB, Vanky E, Carlsen SM. Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Hum Reprod. 2012;27(8):2494–502.

    Article  PubMed  CAS  Google Scholar 

  6. Rosenfield RL, Wroblewski K, Padmanabhan V, Littlejohn E, Mortensen M, Ehrmann DA. Antimüllerian hormone levels are independently related to ovarian hyperandrogenism and polycystic ovaries. Fertil Steril. 2012;98(1):242–9.

    Article  PubMed  CAS  Google Scholar 

  7. Belosi C, Selvaggi L, Apa R, Guido M, Romualdi D, Fulghesu AM, et al. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Hum Reprod. 2006;21(12):3108–15.

    Article  PubMed  CAS  Google Scholar 

  8. Fulghesu AM, Ciampelli M, Belosi C, Apa R, Pavone V, Lanzone A. A new ultrasound criterion for the diagnosis of polycystic ovary syndrome: the ovarian stroma/total area ratio. Fertil Steril. 2001;76(2):326–31.

    Article  PubMed  CAS  Google Scholar 

  9. Wild RA, Vesely S, Beebe L, Whitsett T, Owen W. Ferriman Gallwey self-scoring I: performance assessment in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(7):4112–4.

    Article  PubMed  CAS  Google Scholar 

  10. Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol. 1999;51:779–86.

    Article  CAS  Google Scholar 

  11. March WA, Moore VM, Willson KJ, Phillips DIW, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25(2):544–51.

    Article  PubMed  Google Scholar 

  12. Yildiz BO, Bozdag G, Yapici Z, Esinler I, Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod. 2012;27(10):3067–73.

    Article  PubMed  Google Scholar 

  13. Mehrabian F, Khani B, Kelishadi R, Ghanbari E. The prevalence of polycystic ovary syndrome in Iranian women based on different diagnostic criteria. Polish J Endocrinol. 2011;62(3):238–42.

    Google Scholar 

  14. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern united states: a prospective study. J Clin Endocrinol Metab. 1998;83:3078–82.

    Article  PubMed  CAS  Google Scholar 

  15. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89:2745–9.

    Article  PubMed  CAS  Google Scholar 

  16. Goodarzi MO, Quiñones MJ, Azziz R, Rotter JI, Hsueh WA, Yang H. Polycystic ovary syndrome in Mexican-Americans: prevalence and association with the severity of insulin resistance. Fertil Steril. 2005;84(3):766–9.

    Article  PubMed  Google Scholar 

  17. Moran C, Tena G, Moran S, Ruiz P, Reyna R, Duque X. Prevalence of polycystic ovary syndrome and related disorders in Mexican women. Gynecol Obstet Invest. 2010;69:274–80.

    Article  PubMed  Google Scholar 

  18. Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011;24:223–7.

    Article  PubMed  Google Scholar 

  19. Chhabra S, Venkatraman S. Menstrual dysfunction in rural young women and the presence of polycystic ovarian syndrome. J Obstet Gynaecol. 2010 Jan;30(1):41–5.

    Article  PubMed  CAS  Google Scholar 

  20. Kumarapeli V, Seneviratne RA, Wijeyaratne CN, Yapa RMSC, Dodampahala SH. A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semiurban population in Sri Lanka. Am J Epidemiol. 2008;168:321–8.

    Article  PubMed  CAS  Google Scholar 

  21. Tehrani FR, Rashidi H, Azizi F. The prevalence of idiopathic hirsutism and polycystic ovary syndrome in the Tehran Lipid and Glucose Study. Reprod Biol Endocrinol. 2011;9:144.

    Article  PubMed  Google Scholar 

  22. Diamanti-Kandarakis E, Kouli CR, Bergiele AT, Filandra FA, Tsianateli TC, Spina GG, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84:4006–11.

    Article  PubMed  CAS  Google Scholar 

  23. Boyle JA, Cunningham J, O’Dea K, Dunbar T, Norman RJ. Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia. Med J Aust. 2012;196(1):62–6.

    Article  PubMed  Google Scholar 

  24. Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434–8.

    Article  PubMed  Google Scholar 

  25. DeUgarte CM, Woods KS, Bartolucci AA, Azziz R. Degree of facial and body terminal hair growth in unselected black and white women: toward a populational definition of hirsutism. J Clin Endocrinol Metab. 2006;91(4):1345–50.

    Article  PubMed  CAS  Google Scholar 

  26. Zargar AH, Wani AI, Masoodi SR, Laway BA, Bashir MI, Salahuddin M. Epidemiologic and etiologic aspects of hirsutism in Kashmiri women in the Indian subcontinent. Fertil Steril. 2002;77(4):674–8.

    Article  PubMed  Google Scholar 

  27. Kelekci KH, Kelekci S, Incki K, Ozdemir O, Yilmaz B. Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acne. Int J Dermatol. 2010;49:775–9.

    PubMed  Google Scholar 

  28. Maluki AH. The frequency of polycystic ovary syndrome in females with resistant acne vulgaris. J Cosmet Dermatol. 2010;9:142–8.

    Article  PubMed  Google Scholar 

  29. Wiksten-Almströmer M, Hirschberg AL, Hagenfeldt K. Prospective follow-up of menstrual disorders in adolescence and prognostic factors. Acta Obstet Gynecol Scand. 2008;87:1162–8.

    Article  PubMed  Google Scholar 

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Correspondence to Robert A. Wild M.D., D.Phil., M.P.H. .

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Burks, H.R., Wild, R.A. (2014). Diagnostic Criteria and Epidemiology of PCOS. In: Pal, L. (eds) Polycystic Ovary Syndrome. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8394-6_1

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  • DOI: https://doi.org/10.1007/978-1-4614-8394-6_1

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8393-9

  • Online ISBN: 978-1-4614-8394-6

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