POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: The impact of polycystic ovary syndrome on reproductive health: a narrative review

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. The condition can have an enduring negative effect on women's reproductive health from menarche to menopause, although its impact can vary significantly. PCOS is associated with premature pubarche and a wider age range of menarche. Diagnosis of PCOS in adolescents remains challenging. Oligo/anovulation is the most common feature of PCOS, and leads to subfertility. This may require induction of ovulation with medical therapies, such as oestrogen receptor antagonists, aromatase inhibitors or by giving exogenous follicle-stimulating hormone, which are effective for most women with PCOS. Pregnancy in women with PCOS is associated with a higher risk of complications including gestational diabetes, particularly in those with obesity. Optimisation of pre-conception health, including weight management, is recommended in order to maximise fertility potential and improve pregnancy outcomes. The other key feature of PCOS is hyperandrogenism, which may contribute to ovulatory dysfunction and results in hirsutism and persistent acne, and also negatively impacts mental health, quality of life and psychosexual function. Women with PCOS may also have a later age of menopause, although longitudinal studies are lacking. This narrative review explores the impact of PCOS on women's reproductive health throughout their reproductive lifespan.