The Influence of Study Quality, Age, and Geographic Factors on PCOS Prevalence

Mina Amiri, Sana Hatoum, Richard P Buyalos, Ali Sheidaei, Ricardo Azziz
The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 7, July 2025, Pages 2082–2103
https://doi.org/10.1210/clinem/dgae917

Abstract

Background

Polycystic ovary syndrome (PCOS) is a highly prevalent disorder with substantial burden, yet global epidemiological data remains limited.

Objectives

To estimate the PCOS prevalence globally.

Materials and Methods

We systematically searched PubMed and Embase for PCOS studies in unselected populations through February 2024.

Results

Our study included 88 studies (n = 561 287 women) from 7144 records. The highest PCOS prevalence was identified by the Rotterdam criteria, followed by the Androgen Excess and PCOS Society (AE-PCOS) and the National Institutes of Health (NIH). High-quality studies, as assessed using our newly developed PCOS Epidemiology and Phenotype (PEP) tool, indicated prevalences of 10.89%, 10.61%, and 6.63% using Rotterdam, AE-PCOS, and NIH, respectively. Considering only high-quality studies revealed no significant regional disparities using either NIH [ranging from 5.72% in the Eastern Mediterranean Region (EMR) to 6.90% in the Western Pacific Region (WPR)] or Rotterdam (ranging from 11.15% in South-East Asia to 9.12% in EMR). For AE-PCOS, sufficient data was available only for the WPR region (6.9%). No studies were available in the African Region. A higher PCOS prevalence was observed in adults than adolescents using NIH (8.52% vs 4.44%; P = .01), although the difference diminished when considering only high-quality studies (7.25% vs 4.44%; P = .053). Limited data restricted age-group comparisons using Rotterdam and AE-PCOS.

Conclusion

This systematic review and meta-analysis reveals a trend toward regional variations and age differences across diagnostic criteria. The study results suggest considering study quality using instruments tailored for epidemiological studies in PCOS, such as the PEP tool, when carrying out these types of meta-analyses.

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