Published via DMIHER Center for Advanced
Open Access Review Article Physiotherapy Education & Research
Polycystic Ovary Syndrome: A Literature Review
With a Focus on Diagnosis, Pathophysiology, and
Received 08/21/2023
Management
Review began 10/01/2023
Review ended 10/11/2023 Shrutika V. Waghmare 1 , Amardeep Shanoo 1
Published 10/20/2023
© Copyright 2023 1. Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher
Waghmare et al. This is an open access Education and Research, Wardha, IND
article distributed under the terms of the
Creative Commons Attribution License CC-
Corresponding author: Shrutika V. Waghmare,
BY 4.0., which permits unrestricted use,
distribution, and reproduction in any
medium, provided the original author and
source are credited.
Abstract
DOI: 10.7759/cureus.47408
In females with polycystic ovarian syndrome (PCOS), the most prevalent endocrine condition is chronic
anovulation and hyperandrogenism. This illness influences females from conception to death, posing several
risks to the health of a female, thus reducing the quality of life. It also increases the rates of mortality and
morbidity. The first years of puberty are when PCOS symptoms first show. Menstrual irregularities,
anovulation, and acne are features of both PCOS and typical puberty in females. There are many various
phenotypes that fall under the same illness, so it is necessary to examine each one independently because
they may need different treatments and result in different outcomes. Depending on the diagnostic criteria,
approximately 6%-20% of females in the reproductive age group are believed to be affected by PCOS. As long
as PCOS is still a syndrome, no single diagnostic indicator, such as hyperandrogenism or polycystic ovary
(PCO), can be used to make a clinical diagnosis. The management of females with PCOS depends on the
symptoms. These could include menstruation problems, androgen-related symptoms, or infertility caused by
ovulatory disruption. In females with PCOS, anovulation is linked to low follicle-stimulating hormone (FSH)
levels and a halt in antral follicle growth during the last stages of maturation. The condition may be treated
surgically with laparoscopic ovarian drilling or medically with medications such as aromatase inhibitors,
metformin, glucocorticoids, clomiphene citrate (CC), tamoxifen, or gonadotropins. Patients will experience
different androgenic symptoms, such as hirsutism, acne, and/or baldness. Patients who appear with these
troubling symptoms need to receive appropriate care. The review emphasizes the role it plays in the
management of various conditions.
Categories: Endocrinology/Diabetes/Metabolism, Epidemiology/Public Health, Obstetrics/Gynecology
Keywords: pcos treatment, insulin resistance, hyperandrogenism, diagnostic criteria, polycystic ovary syndrome
Introduction And Background
Worldwide, affecting many females in the reproductive age group, polycystic ovary syndrome (PCOS) is
considered to be a heterogeneous endocrine disorder characterized by hyperandrogenism, ovulation
dysfunction, and the morphology of polycystic ovary (PCO) [1]. Depending on the parameters defined, PCOS
has a reported prevalence in the community of 6%-10% [2]. PCOS affects females from the moment of birth
to the moment of death, providing a range of health hazards that may reduce their quality of life. It also
contributes significantly to morbidity and mortality in the reproductive age group. With the most recent
medical literature, the aim of this review is to summarize the medical effects from the start of reproductive
life to its end (Figure 1) [3].
How to cite this article
Waghmare S V, Shanoo A (October 20, 2023) Polycystic Ovary Syndrome: A Literature Review With a Focus on Diagnosis, Pathophysiology, and
Management. Cureus 15(10): e47408. DOI 10.7759/cureus.47408
, Published via DMIHER Center for Advanced
Physiotherapy Education & Research
FIGURE 1: Clinical manifestations of PCOS in different stages of life of
females
Credits: Shrutika Waghmare
IUGR, intrauterine growth retardation; SGA, small for gestational age; PCOS, polycystic ovarian syndrome
Sixteen phenotypes with various metabolic and reproductive effects may exist depending on the
characteristics of the disease taken into consideration. There were four main phenotypes reported based on
the Rotterdam criteria (Figure 2) [2,3]. The 2003 Rotterdam Consensus Workshop determined that PCOS is a
syndrome of ovarian dysfunction on the basis of the cardinal features of hyperandrogenism and the
morphology of polycystic ovary (PCO) [4]. The data suggests that this disorder affects between 6% and 8% of
females globally if diagnosed using the National Institutes of Health 1990 criteria. As a result, it can be
regarded as one of the most common disorders overall and also the most common endocrine abnormality in
the reproductive age group [4].
2023 Waghmare et al. Cureus 15(10): e47408. DOI 10.7759/cureus.47408 2 of 10
Open Access Review Article Physiotherapy Education & Research
Polycystic Ovary Syndrome: A Literature Review
With a Focus on Diagnosis, Pathophysiology, and
Received 08/21/2023
Management
Review began 10/01/2023
Review ended 10/11/2023 Shrutika V. Waghmare 1 , Amardeep Shanoo 1
Published 10/20/2023
© Copyright 2023 1. Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher
Waghmare et al. This is an open access Education and Research, Wardha, IND
article distributed under the terms of the
Creative Commons Attribution License CC-
Corresponding author: Shrutika V. Waghmare,
BY 4.0., which permits unrestricted use,
distribution, and reproduction in any
medium, provided the original author and
source are credited.
Abstract
DOI: 10.7759/cureus.47408
In females with polycystic ovarian syndrome (PCOS), the most prevalent endocrine condition is chronic
anovulation and hyperandrogenism. This illness influences females from conception to death, posing several
risks to the health of a female, thus reducing the quality of life. It also increases the rates of mortality and
morbidity. The first years of puberty are when PCOS symptoms first show. Menstrual irregularities,
anovulation, and acne are features of both PCOS and typical puberty in females. There are many various
phenotypes that fall under the same illness, so it is necessary to examine each one independently because
they may need different treatments and result in different outcomes. Depending on the diagnostic criteria,
approximately 6%-20% of females in the reproductive age group are believed to be affected by PCOS. As long
as PCOS is still a syndrome, no single diagnostic indicator, such as hyperandrogenism or polycystic ovary
(PCO), can be used to make a clinical diagnosis. The management of females with PCOS depends on the
symptoms. These could include menstruation problems, androgen-related symptoms, or infertility caused by
ovulatory disruption. In females with PCOS, anovulation is linked to low follicle-stimulating hormone (FSH)
levels and a halt in antral follicle growth during the last stages of maturation. The condition may be treated
surgically with laparoscopic ovarian drilling or medically with medications such as aromatase inhibitors,
metformin, glucocorticoids, clomiphene citrate (CC), tamoxifen, or gonadotropins. Patients will experience
different androgenic symptoms, such as hirsutism, acne, and/or baldness. Patients who appear with these
troubling symptoms need to receive appropriate care. The review emphasizes the role it plays in the
management of various conditions.
Categories: Endocrinology/Diabetes/Metabolism, Epidemiology/Public Health, Obstetrics/Gynecology
Keywords: pcos treatment, insulin resistance, hyperandrogenism, diagnostic criteria, polycystic ovary syndrome
Introduction And Background
Worldwide, affecting many females in the reproductive age group, polycystic ovary syndrome (PCOS) is
considered to be a heterogeneous endocrine disorder characterized by hyperandrogenism, ovulation
dysfunction, and the morphology of polycystic ovary (PCO) [1]. Depending on the parameters defined, PCOS
has a reported prevalence in the community of 6%-10% [2]. PCOS affects females from the moment of birth
to the moment of death, providing a range of health hazards that may reduce their quality of life. It also
contributes significantly to morbidity and mortality in the reproductive age group. With the most recent
medical literature, the aim of this review is to summarize the medical effects from the start of reproductive
life to its end (Figure 1) [3].
How to cite this article
Waghmare S V, Shanoo A (October 20, 2023) Polycystic Ovary Syndrome: A Literature Review With a Focus on Diagnosis, Pathophysiology, and
Management. Cureus 15(10): e47408. DOI 10.7759/cureus.47408
, Published via DMIHER Center for Advanced
Physiotherapy Education & Research
FIGURE 1: Clinical manifestations of PCOS in different stages of life of
females
Credits: Shrutika Waghmare
IUGR, intrauterine growth retardation; SGA, small for gestational age; PCOS, polycystic ovarian syndrome
Sixteen phenotypes with various metabolic and reproductive effects may exist depending on the
characteristics of the disease taken into consideration. There were four main phenotypes reported based on
the Rotterdam criteria (Figure 2) [2,3]. The 2003 Rotterdam Consensus Workshop determined that PCOS is a
syndrome of ovarian dysfunction on the basis of the cardinal features of hyperandrogenism and the
morphology of polycystic ovary (PCO) [4]. The data suggests that this disorder affects between 6% and 8% of
females globally if diagnosed using the National Institutes of Health 1990 criteria. As a result, it can be
regarded as one of the most common disorders overall and also the most common endocrine abnormality in
the reproductive age group [4].
2023 Waghmare et al. Cureus 15(10): e47408. DOI 10.7759/cureus.47408 2 of 10
