Prevalence, Risk Factors and Management of Polycystic Ovary Syndrome: A Review with Current Evidence

Authors

  • Sajjan Iqbal Memon Research Assistant, Department of Health Administration, King Saud University, Riyadh, Saudi Arabia
  • Misbah Shakeel Lecturer, Department of Physiotherapy, Iqra University, Chak Shahzad Campus Islamabad, Pakistan
  • Hafsa Syed Lecturer, Department of Physiotherapy, National Institute of Physiotherapy & Rehabilitation Medicine (NIPRM), Hyderabad, Pakistan
  • Kinza Amin Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan
  • Aya A Khalil Department of Biomechanics, Faculty of physical therapy Cairo University, Egypt
  • Maryam Sulaiman Lecturer, Department of Physiotherapy, Iqra University, Chak Shahzad Campus, Islamabad, Pakistan

DOI:

https://doi.org/10.22317/imj.v8i1.1268

Keywords:

Polycystic ovary syndrome, Prevalence, Women, Hormonal imbalances, Reproductive health, Endocrine disorder, Diet, Physical activity.

Abstract

Objectives: This review is aimed to examine polycystic ovary syndrome, its prevalence, pathophysiology, risk factors, and viable management options.

Methods: A systematic literature search was conducted across prominent databases, including PubMed, Scopus, EMBASE, Web of Science, and Google Scholar. We included English-language articles published between 1990 and 2021. The search strategy involved utilizing keywords such as "polycystic ovary syndrome," "prevalence," "risk factors," "PCOS management," "diet and PCOS," "physical activity," and ‘’exercise effects’’ We thoroughly reviewed the selected studies to identify literature trends and correlations through data synthesis.

Results: The findings from 45 full-text articles has indicated that the prevalence rates of PCOS have been found to range among many groups, as evidenced by several studies. Several studies have identified genetics, insulin resistance, and obesity as significant risk factors associated with the development of this condition. The study also revealed that lifestyle factors, specifically nutrition and physical exercise, exerted an impact on insulin sensitivity, weight regulation, and reproductive health among women diagnosed with PCOS. The implementation of interventions aimed at promoting healthier lifestyle choices has favorable results in the management of symptoms associated with PCOS.

Conclusion: It is imperative to incorporate lifestyle modifications that encompass a well-balanced nutritional plan and consistent physical activity. Public health interventions that prioritize raising awareness and implementing targeted strategies have the potential to empower women, enabling them to make healthier lifestyle choices. This, in turn, can help reduce the adverse effects of PCOS on their general well-being.

References

Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human reproduction. 2018 Sep 1;33(9):1602–18.

Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Natterson-Horowtiz B, Teede HJ, Yildiz BO. Polycystic ovary syndrome. Nature reviews Disease primers. 2016 Aug 11;2(1):1–8.

Cheung AP, Chang RJ. Polycystic ovary syndrome. Clinical obstetrics and gynecology. 1990 Sep 1;33(3):655–7.

Rotterdam ES. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.

Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618–637.

Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, Lobo R, Norman RJ, Talbott E, Dumesic DA. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. The Journal of Clinical Endocrinology & Metabolism. 2010 May 1;95(5):2038–49.

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine reviews. 2012 Dec 1;33(6):981–1030.

Hayes MG, Urbanek M, Ehrmann DA, Armstrong LL, Lee JY, Sisk R, Karaderi T, Barber TM, McCarthy MI, Franks S, Lindgren CM. Genome-wide association of polycystic ovary syndrome implicates alterations in gonadotropin secretion in European ancestry populations. Nature communications. 2015 Aug 18;6(1):7502.

Day FR, Hinds DA, Tung JY, Stolk L, Styrkarsdottir U, Saxena R, Bjonnes A, Broer L, Dunger DB, Halldorsson BV, Lawlor DA. Causal mechanisms and balancing selection inferred from genetic associations with polycystic ovary syndrome. Nature communications. 2015 Sep 29;6(1):8464.

Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2011(7).

Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2019(3).

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. The Journal of Clinical Endocrinology & Metabolism. 2004 Jun 1;89(6):2745–9.

Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, Escobar-Morreale HF. Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Human reproduction update. 2014 May 1;20(3):334–52.

Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology. 2018 May;14(5):270–84.

Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2013 Dec 1;98(12):4565–92.

Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM, Hart R, Johnson L, Jordan C, Legro RS, Norman RJ. Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Human reproduction open. 2019;2019(1):hoy021.

Torres PJ, Siakowska M, Banaszewska B, Pawelczyk L, Duleba AJ, Kelley ST, Thackray VG. Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism. The Journal of Clinical Endocrinology & Metabolism. 2018 Apr;103(4):1502–11.

Qi X, Yun C, Sun L, Xia J, Wu Q, Wang Y, Wang L, Zhang Y, Liang X, Wang L, Gonzalez FJ. Gut microbiota–bile acid–interleukin-22 axis orchestrates polycystic ovary syndrome. Nature medicine. 2019 Aug;25(8):1225–33.

Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction. 2016 Dec 1;31(12):2841–55.

Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertility and sterility. 2016 Jul 1;106(1):6–15.

Teede HJ, Joham AE, Paul E, Moran LJ, Loxton D, Jolley D, Lombard C. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity. 2013 Aug;21(8):1526–32.

Franks S, McCarthy MI, Hardy K. Development of polycystic ovary syndrome: involvement of genetic and environmental factors. International journal of andrology. 2006 Feb;29(1):278–85.

Toulis KA, Goulis DG, Farmakiotis D, Georgopoulos NA, Katsikis I, Tarlatzis BC, Papadimas I, Panidis D. Adiponectin levels in women with polycystic ovary syndrome: a systematic review and a meta-analysis. Human reproduction update. 2009 May 1;15(3):297–307.

Barrett ES, Hoeger KM, Sathyanarayana S, Abbott DH, Redmon JB, Nguyen RH, Swan SH. Anogenital distance in newborn daughters of women with polycystic ovary syndrome indicates fetal testosterone exposure. Journal of developmental origins of health and disease. 2018 Jun;9(3):307–14.

Louwers YV, Stolk L, Uitterlinden AG, Laven JS. Cross-ethnic meta-analysis of genetic variants for polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2013 Dec 1;98(12):E2006–12.

Barber TM, Franks S. Genetics of polycystic ovary syndrome. Polycystic ovary syndrome. 2013;40:28–39.

Wolff MS, Engel SM, Berkowitz GS, Ye X, Silva MJ, Zhu C, Wetmur J, Calafat AM. Prenatal phenol and phthalate exposures and birth outcomes. Environmental health perspectives. 2008 Aug;116(8):1092–7.

Hoeger KM, Kochman L, Wixom N, Craig K, Miller RK, Guzick DS. A randomized, 48-week, placebo-controlled trial of intensive lifestyle modification and/or metformin therapy in overweight women with polycystic ovary syndrome: a pilot study. Fertility and sterility. 2004 Aug 1;82(2):421–9.

Morin-Papunen L, Rautio K, Ruokonen A, Hedberg P, Puukka M, Tapanainen JS. Metformin reduces serum C-reactive protein levels in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2003 Oct 1;88(10):4649–54.

Ibáñez L, Oberfield SE, Witchel S, Auchus RJ, Chang RJ, Codner E, Dabadghao P, Darendeliler F, Elbarbary NS, Gambineri A, Garcia Rudaz C. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Hormone research in paediatrics. 2017 Jun 1;88(6):371–95.

Eleftheriadou M, Stefanidis K, Lykeridou K, Iliadis I, Michala L. Dietary habits in adolescent girls with polycystic ovarian syndrome. Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology. 2014 Nov 28;31(4):269–71.

Kiddy DS, Hamilton‐Fairley D, Bush A, Short F, Anyaoku V, Reed MJ, et al. Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clinical endocrinology. 1992;36(1):105–11.

Wright CE, Zborowski JV, Talbott EO, McHugh-Pemu K, Youk A. Dietary intake, physical activity, and obesity in women with polycystic ovary syndrome. International journal of obesity. 2004 Aug;28(8):1026–32.

Marsh K, Brand-Miller J. The optimal diet for women with polycystic ovary syndrome?. British Journal of Nutrition. 2005 Aug;94(2):154–65.

Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC medicine. 2010 Dec;8(1):1–0.

Banting LK, Gibson-Helm M, Polman R, Teede HJ, Stepto NK. Physical activity and mental health in women with polycystic ovary syndrome. BMC women’s health. 2014 Dec;14(1):1–9.

Jedel E, Labrie F, Odén A, Holm G, Nilsson L, Janson PO, Lind AK, Ohlsson C, Stener-Victorin E. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. American Journal of Physiology-Endocrinology and Metabolism. 2011 Jan;300(1):E37–45.

Conte F, Banting L, Teede HJ, Stepto NK. Mental health and physical activity in women with polycystic ovary syndrome: a brief review. Sports Medicine. 2015 Apr;45:497–504.

Tariq R, Riaz H, Afzal K, Memon SI, Kainat S, Asif R. Dietary and physical activity patterns among patients with polycystic ovary syndrome. Rawal Medical Journal. 2021 Jan;46(1).

Chen ZJ, Shi Y. Polycystic ovary syndrome. Frontiers of medicine in China. 2010 Sep;4:280–4.

Huber-Buchholz MM, Carey DG, Norman RJ. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. The Journal of Clinical Endocrinology & Metabolism. 1999 Apr 1;84(4):1470–4.

Lass N, Kleber M, Winkel K, Wunsch R, Reinehr T. Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls. The Journal of Clinical Endocrinology & Metabolism. 2011 Nov 1;96(11):3533–40.

Hoeger KM. Obesity in polycystic ovary syndrome: Insulin sensitizing therapy. Current Obesity Reports. 2012 Dec;1:191–8.

Hassan S, Minhaj S, Khan R, Saleem R, Memon SI, Amjad B. exercise improves physical function in geriatrics. 2019 Jul;10(7): 1012–16.

Qureshi F, Memon SI. Sedentary lifestyle and health factors as leading cause of diseases: A multi centered study. Rawal Medical Journal. 2020 Jul;45(3):707.

Rojas J, Chávez M, Olivar L, Rojas M, Morillo J, Mejías J, Calvo M, Bermúdez V. Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. International journal of reproductive medicine. 2014 Oct;2014.

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Published

2024-03-27

How to Cite

Iqbal Memon, S. ., Shakeel, M. ., Syed, H. ., Amin, K. ., A Khalil, A. ., & Sulaiman, M. . (2024). Prevalence, Risk Factors and Management of Polycystic Ovary Syndrome: A Review with Current Evidence. Iraq Medical Journal, 8(1). https://doi.org/10.22317/imj.v8i1.1268