6533b7d8fe1ef96bd126af0a

RESEARCH PRODUCT

Lifecycle of Polycystic Ovary Syndrome (PCOS): From In Utero to Menopause

Corrine K. WeltEnrico Carmina

subject

Senescencemedicine.medical_specialtySettore MED/09 - Medicina Internaendocrine system diseasesEndocrinology Diabetes and MetabolismClinical BiochemistryContext (language use)BiochemistrySettore MED/13 - EndocrinologiaAnovulationEndocrinologySettore MED/38 - Pediatria Generale E SpecialisticaInternal medicinemedicinePregnancybusiness.industryPolycystic ovary syndrome (PCOS)Biochemistry (medical)Hyperandrogenismnutritional and metabolic diseasesmedicine.diseasePolycystic ovaryPCOS Pregnancy infancy puberty menopause obesity AMH cardiovascular risk birth weightSettore MED/40 - Ginecologia E Ostetriciafemale genital diseases and pregnancy complicationsMenopauseEndocrinologybusiness

description

Context: Polycystic ovary syndrome (PCOS) is diagnosed during the reproductive years when women present with 2 of 3 of the following criteria: 1) irregular menstrual cycles or anovulation, 2) hyperandrogenism, and 3) PCO morphology. However, there is evidence that PCOS can be identified from early infancy to puberty based on predisposing environmental influences. There is also increasing information about the PCOS phenotype after menopause. The goal of this review is to summarize current knowledge about the appearance of PCOS at different life stages and the influence of reproductive maturation and senescence on the PCOS phenotype. Evidence: PubMed, the bibliography from the Evidence-Based PCOS Workshop, and the reference lists from identified manuscripts were reviewed. Evidence Synthesis: The current data suggest that daughters of women with PCOS have a greater follicle complement and mild metabolic abnormalities from infancy. PCOS is often diagnosed in puberty with the onset of hyperandrogenismandmaybepreceded by premature pubarche. During the reproductive years, there is a gradual decrease in the severity of the cardinal features of PCOS. Menopausal data suggest that the majority of women who had PCOS during their reproductive years continue to manifest cardiovascular risk factors. However, the majority do not present an increased risk for cardiovascular morbidity and mortality, perhaps because women with no history of PCOS may catch up after menopause. Conclusion: The current data provide a comprehensive starting point to understand the phenotype of PCOS across the lifespan. However, limitations such as a bias of ascertainment in childhood, age-based changes during reproductive life, and the small numbers studied during menopause point to the need for additional longitudinal studies to expand the current knowledge

10.1210/jc.2013-2375http://hdl.handle.net/10447/102043