Editing Polycystic ovary syndrome (section)

== Epidemiology ==
PCOS is the most common [[endocrine disorder]] among women between the ages of 18 and 44.<ref name="BMC2010">{{cite journal | vauthors = Teede H, Deeks A, Moran L | title = Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan | journal = BMC Medicine | volume = 8 | issue = 1 | page = 41 | date = June 2010 | pmid = 20591140 | pmc = 2909929 | doi = 10.1186/1741-7015-8-41 | doi-access = free }}</ref> It affects approximately 2% to 20% of this age group depending on how it is defined.<ref name="NICHD What causes PCOS?" /><ref name=Lub2013>{{cite book| veditors = Pal L |title=Polycystic Ovary Syndrome Current and Emerging Concepts|date=2013|publisher=Springer|location=Dordrecht|isbn=978-1-4614-8394-6|page=7|chapter-url=https://books.google.com/books?id=DTUnAQAAQBAJ&q=Polycystic%20Ovary%20Syndrome%3B%20Subtitle%3A%20Current%20and%20Emerging%20Concepts%3B%20Part%20I&pg=PA7|chapter=Diagnostic Criteria and Epidemiology of PCOS|url-status=live|archive-url=https://web.archive.org/web/20170910181322/https://books.google.com/books?id=DTUnAQAAQBAJ&lpg=PP1&pg=PA7|archive-date=10 September 2017}}</ref> When someone is infertile due to lack of ovulation, PCOS is the most common cause and could guide to patients' diagnosis.<ref name=NIH2017Def/> The earliest known description of what is now recognized as PCOS dates from 1721 in Italy.<ref name="Kovacs2007">{{cite book| vauthors = Kovacs GT, Norman R |title=Polycystic Ovary Syndrome|url=https://books.google.com/books?id=bpn1u9hziVgC&pg=PA4|access-date=29 March 2013|date=22 February 2007|publisher=Cambridge University Press|isbn=978-1-139-46203-7|page=4|url-status=live|archive-url=https://web.archive.org/web/20130616151243/http://books.google.com/books?id=bpn1u9hziVgC&pg=PA4|archive-date=16 June 2013}}</ref>
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The prevalence of PCOS depends on the choice of diagnostic criteria. The [[World Health Organization]] estimates that it affects 116&nbsp;million women worldwide as of 2010 (3.4% of women).<ref name="LancetEpi2012">{{cite journal | vauthors = Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D, Bernabé E, Bhalla K, Bhandari B, Bikbov B, Bin Abdulhak A, Birbeck G, Black JA, Blencowe H, Blore JD, Blyth F, Bolliger I, Bonaventure A, Boufous S, Bourne R, Boussinesq M, Braithwaite T, Brayne C, Bridgett L, Brooker S, Brooks P, Brugha TS, Bryan-Hancock C, Bucello C, Buchbinder R, Buckle G, Budke CM, Burch M, Burney P, Burstein R, Calabria B, Campbell B, Canter CE, Carabin H, Carapetis J, Carmona L, Cella C, Charlson F, Chen H, Cheng AT, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahiya M, Dahodwala N, Damsere-Derry J, Danaei G, Davis A, De Leo D, Degenhardt L, Dellavalle R, Delossantos A, Denenberg J, Derrett S, Des Jarlais DC, Dharmaratne SD, Dherani M, Diaz-Torne C, Dolk H, Dorsey ER, Driscoll T, Duber H, Ebel B, Edmond K, Elbaz A, Ali SE, Erskine H, Erwin PJ, Espindola P, Ewoigbokhan SE, Farzadfar F, Feigin V, Felson DT, Ferrari A, Ferri CP, Fèvre EM, Finucane MM, Flaxman S, Flood L, Foreman K, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabbe BJ, Gabriel SE, Gakidou E, Ganatra HA, Garcia B, Gaspari F, Gillum RF, Gmel G, Gosselin R, Grainger R, Groeger J, Guillemin F, Gunnell D, Gupta R, Haagsma J, Hagan H, Halasa YA, Hall W, Haring D, Haro JM, Harrison JE, Havmoeller R, Hay RJ, Higashi H, Hill C, Hoen B, Hoffman H, Hotez PJ, Hoy D, Huang JJ, Ibeanusi SE, Jacobsen KH, James SL, Jarvis D, Jasrasaria R, Jayaraman S, Johns N, Jonas JB, Karthikeyan G, Kassebaum N, Kawakami N, Keren A, Khoo JP, King CH, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lalloo R, Laslett LL, Lathlean T, Leasher JL, Lee YY, Leigh J, Lim SS, Limb E, Lin JK, Lipnick M, Lipshultz SE, Liu W, Loane M, Ohno SL, Lyons R, Ma J, Mabweijano J, MacIntyre MF, Malekzadeh R, Mallinger L, Manivannan S, Marcenes W, March L, Margolis DJ, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGill N, McGrath J, Medina-Mora ME, Meltzer M, Mensah GA, Merriman TR, Meyer AC, Miglioli V, Miller M, Miller TR, Mitchell PB, Mocumbi AO, Moffitt TE, Mokdad AA, Monasta L, Montico M, Moradi-Lakeh M, Moran A, Morawska L, Mori R, Murdoch ME, Mwaniki MK, Naidoo K, Nair MN, Naldi L, Narayan KM, Nelson PK, Nelson RG, Nevitt MC, Newton CR, Nolte S, Norman P, Norman R, O'Donnell M, O'Hanlon S, Olives C, Omer SB, Ortblad K, Osborne R, Ozgediz D, Page A, Pahari B, Pandian JD, Rivero AP, Patten SB, Pearce N, Padilla RP, Perez-Ruiz F, Perico N, Pesudovs K, Phillips D, Phillips MR, Pierce K, Pion S, Polanczyk GV, Polinder S, Pope CA, Popova S, Porrini E, Pourmalek F, Prince M, Pullan RL, Ramaiah KD, Ranganathan D, Razavi H, Regan M, Rehm JT, Rein DB, Remuzzi G, Richardson K, Rivara FP, Roberts T, Robinson C, De Leòn FR, Ronfani L, Room R, Rosenfeld LC, Rushton L, Sacco RL, Saha S, Sampson U, Sanchez-Riera L, Sanman E, Schwebel DC, Scott JG, Segui-Gomez M, Shahraz S, Shepard DS, Shin H, Shivakoti R, Singh D, Singh GM, Singh JA, Singleton J, Sleet DA, Sliwa K, Smith E, Smith JL, Stapelberg NJ, Steer A, Steiner T, Stolk WA, Stovner LJ, Sudfeld C, Syed S, Tamburlini G, Tavakkoli M, Taylor HR, Taylor JA, Taylor WJ, Thomas B, Thomson WM, Thurston GD, Tleyjeh IM, Tonelli M, Towbin JA, Truelsen T, Tsilimbaris MK, Ubeda C, Undurraga EA, van der Werf MJ, van Os J, Vavilala MS, Venketasubramanian N, Wang M, Wang W, Watt K, Weatherall DJ, Weinstock MA, Weintraub R, Weisskopf MG, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams SR, Witt E, Wolfe F, Woolf AD, Wulf S, Yeh PH, Zaidi AK, Zheng ZJ, Zonies D, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA | title = Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2163–96 | date = December 2012 | pmid = 23245607 | pmc = 6350784 | doi = 10.1016/S0140-6736(12)61729-2 }}</ref> Another estimate indicates that 7% of women of reproductive age are affected.<ref>{{cite journal | vauthors = McLuskie I, Newth A | title = New diagnosis of polycystic ovary syndrome | journal = BMJ | volume = 356 | pages = i6456 | date = January 2017 | pmid = 28082338 | doi = 10.1136/bmj.i6456 | hdl-access = free | s2cid = 13042313 | hdl = 10044/1/44217 }}</ref> Another study using the Rotterdam criteria found that about 18% of women had PCOS, and that 70% of them were previously undiagnosed.<ref name=BMC2010/> Prevalence also varies across countries due to a lack of large-scale scientific studies; India, for example, has a purported rate of 1 in 5 women having PCOS.<ref>{{Cite news|title=One in five Indian women suffers from PCOS|url=https://www.thehindu.com/sci-tech/health/one-in-five-indian-women-suffers-from-pcos/article29513588.ece|access-date=16 April 2021|website=The Hindu|date=26 September 2019|vauthors=Pruthi B|archive-date=15 April 2021|archive-url=https://web.archive.org/web/20210415203505/https://www.thehindu.com/sci-tech/health/one-in-five-indian-women-suffers-from-pcos/article29513588.ece|url-status=live}}</ref>

Few studies have investigated the racial differences in cardiometabolic factors in women with PCOS.<ref>{{cite journal |vauthors=Chahal N, Quinn M, Jaswa EA, Kao CN, Cedars MI, Huddleston HG |date=December 2020 |title=Comparison of metabolic syndrome elements in White and Asian women with polycystic ovary syndrome: results of a regional, American cross-sectional study |journal=F&S Reports |volume=1 |issue=3 |pages=305–313 |doi=10.1016/j.xfre.2020.09.008 |pmc=8244318 |pmid=34223261}}</ref> There is also limited data on the racial differences in the risk of metabolic syndrome and cardiovascular disease in adolescents and young adults with PCOS.<ref>{{cite journal | vauthors = Ladson G, Dodson WC, Sweet SD, Archibong AE, Kunselman AR, Demers LM, Williams NI, Coney P, Legro RS | title = Racial influence on the polycystic ovary syndrome phenotype: a black and white case-control study | journal = Fertility and Sterility | volume = 96 | issue = 1 | pages = 224–9.e2 | date = July 2011 | pmid = 21723443 | pmc = 3132396 | doi = 10.1016/j.fertnstert.2011.05.002 }}</ref> The first study to comprehensively examine racial differences discovered notable racial differences in risk factors for cardiovascular disease. African American women were found to be significantly more obese, with a significantly higher prevalence of metabolic syndrome compared to white adult women with PCOS.<ref>{{Cite journal| vauthors = Hillman JK, Johnson LN, Limaye M, Feldman RA, Sammel M, Dokras A |date=September 2013|title=Black women with polycystic ovary syndrome (PCOS) have increased risk for metabolic syndrome (MET SYN) and cardiovascular disease (CVD) compared to white women with PCOS |journal=Fertility and Sterility |volume=100 |issue=3 |pages=S100–1 |doi= 10.1016/j.fertnstert.2013.07.1707 |doi-access=free }}</ref> It is important for the further research of racial differences among women with PCOS, to ensure that every person that is affected by PCOS has the available resources for management.<ref>{{cite journal | vauthors = Elghobashy M, Lau GM, Davitadze M, Gillett CD, O'Reilly MW, Arlt W, Lindenmeyer A, Kempegowda P | title = Concerns and expectations in women with polycystic ovary syndrome vary across age and ethnicity: findings from PCOS Pearls Study | journal = Frontiers in Endocrinology | volume = 14 | pages = 1175548 | date = 2023 | pmid = 37621648 | pmc = 10446892 | doi = 10.3389/fendo.2023.1175548 | doi-access = free }}</ref><ref>{{cite journal |vauthors=Teede HJ, Tay CT, Laven JJ, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE |title=Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome |journal=J Clin Endocrinol Metab |volume=108 |issue=10 |pages=2447–69 |date=September 2023 |pmid=37580314 |pmc=10505534 |doi=10.1210/clinem/dgad463 }}</ref>

Ultrasonographic findings of polycystic ovaries are found in 8–25% of women non-affected by the syndrome.<ref>{{cite journal | vauthors = Polson DW, Adams J, Wadsworth J, Franks S | title = Polycystic ovaries--a common finding in normal women | journal = Lancet | volume = 1 | issue = 8590 | pages = 870–2 | date = April 1988 | pmid = 2895373 | doi = 10.1016/s0140-6736(88)91612-1 | s2cid = 41297081 }}</ref><ref name="clayton">{{cite journal | vauthors = Clayton RN, Ogden V, Hodgkinson J, Worswick L, Rodin DA, Dyer S, Meade TW | title = How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? | journal = Clinical Endocrinology | volume = 37 | issue = 2 | pages = 127–134 | date = August 1992 | pmid = 1395063 | doi = 10.1111/j.1365-2265.1992.tb02296.x | s2cid = 12384062 }}</ref><ref name="pmid8053879">{{cite journal | vauthors = Farquhar CM, Birdsall M, Manning P, Mitchell JM, France JT | title = The prevalence of polycystic ovaries on ultrasound scanning in a population of randomly selected women | journal = The Australian & New Zealand Journal of Obstetrics & Gynaecology | volume = 34 | issue = 1 | pages = 67–72 | date = February 1994 | pmid = 8053879 | doi = 10.1111/j.1479-828X.1994.tb01041.x | s2cid = 312422 }}</ref><ref name="pmid9091329">{{cite journal | vauthors = van Santbrink EJ, Hop WC, Fauser BC | title = Classification of normogonadotropic infertility: polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome | journal = Fertility and Sterility | volume = 67 | issue = 3 | pages = 452–8 | date = March 1997 | pmid = 9091329 | doi = 10.1016/S0015-0282(97)80068-4 | doi-access = free }}</ref> 14% women on oral contraceptives are found to have polycystic ovaries.<ref name="clayton" /> Ovarian cysts are also a common side effect of levonorgestrel-releasing [[intrauterine device]]s (IUDs).<ref>{{cite journal | vauthors = Hardeman J, Weiss BD | title = Intrauterine devices: an update | journal = American Family Physician | volume = 89 | issue = 6 | pages = 445–450 | date = March 2014 | pmid = 24695563 }}</ref>