Polycystic Ovary Syndrome: Criteria, Phenotypes, Race and Ethnicity

Overview

Journal Reprod Med Biol

Date 2025 Jan 23

PMID 39845478

Authors

Tsuyoshi Baba

Affiliations

Soon will be listed here.

Abstract

Background: Polycystic ovary syndrome (PCOS) is a complex endocrinopathy, which leads to ovulation dysfunction and infertility, as well as metabolic and mental disorders. Women with PCOS exhibit several characteristic symptoms, with marked heterogeneity across different races and ethnicities.

Methods: In this review, the author outlines the phenotypic disparities of PCOS among various racial and ethnic populations. First, the prevalence of major symptoms in different racial and ethnic groups with PCOS is summarized. Next, the effects of four phenotypes, derived from the Rotterdam criteria for PCOS, on metabolic and reproductive features are recapitulated.

Main Findings: A growing body of evidence suggests that East Asian populations exhibit less hirsutism and adiposity compared with other groups. However, hirsutism is more prevalent in South Asian, Middle Eastern, and Hispanic populations. Hispanic and African American populations have more frequent obesity and insulin resistance. With regard to the association between mental disorders and racial and ethnic differences, limited studies exist; therefore, no conclusions can be drawn.

Conclusion: Race and ethnicity-specific factors related to PCOS must be considered in clinical practice. The diagnostic criteria of PCOS should be specific to race and ethnicity to avoid missing treatment opportunities.

Citing Articles

Polycystic ovary syndrome: Criteria, phenotypes, race and ethnicity.

Baba T Reprod Med Biol. 2025; 24(1):e12630.

PMID: 39845478 PMC: 11751892. DOI: 10.1002/rmb2.12630.

References

Payne K, Lipshultz L, Hotaling J, Pastuszak A . Obstructive Sleep Apnea and Testosterone Therapy. Sex Med Rev. 2020; 9(2):296-303. DOI: 10.1016/j.sxmr.2020.04.004. View

Greenwood E, Pasch L, Cedars M, Legro R, Eisenberg E, Huddleston H . Insulin resistance is associated with depression risk in polycystic ovary syndrome. Fertil Steril. 2018; 110(1):27-34. PMC: 6392023. DOI: 10.1016/j.fertnstert.2018.03.009. View

Pamplin Ii J, Rudolph K, Keyes K, Susser E, Bates L . Investigating a Paradox: Toward a Better Understanding of the Relationships Between Racial Group Membership, Stress, and Major Depressive Disorder. Am J Epidemiol. 2023; 192(11):1845-1853. PMC: 11043785. DOI: 10.1093/aje/kwad128. View

Shahrami S, Ranjbar Z, Milani F, Kezem-Nejad E, Hassanzadeh Rad A, Dalil Heirat S . The Relation between Diverse Phenotypes of PCOS with Clinical Manifestations, Anthropometric Indices and Metabolic Characteristics. Acta Med Iran. 2016; 54(2):134-9. View

Azziz R . The evaluation and management of hirsutism. Obstet Gynecol. 2003; 101(5 Pt 1):995-1007. DOI: 10.1016/s0029-7844(02)02725-4. View

Broughton D, Moley K . Obesity and female infertility: potential mediators of obesity's impact. Fertil Steril. 2017; 107(4):840-847. DOI: 10.1016/j.fertnstert.2017.01.017. View

Uk A, Decanter C, Grysole C, Keller L, Behal H, Silva M . Polycystic ovary syndrome phenotype does not have impact on oocyte morphology. Reprod Biol Endocrinol. 2022; 20(1):7. PMC: 8729101. DOI: 10.1186/s12958-021-00874-2. View

Meyer M, Sotres-Alvarez D, Steiner A, Cousins L, Talavera G, Cai J . Polycystic Ovary Syndrome Signs and Metabolic Syndrome in Premenopausal Hispanic/Latina Women: the HCHS/SOL Study. J Clin Endocrinol Metab. 2020; 105(3). PMC: 7007876. DOI: 10.1210/clinem/dgaa012. View

Wijeyaratne C, Seneviratne R, Dahanayake S, Kumarapeli V, Palipane E, Kuruppu N . Phenotype and metabolic profile of South Asian women with polycystic ovary syndrome (PCOS): results of a large database from a specialist Endocrine Clinic. Hum Reprod. 2010; 26(1):202-13. DOI: 10.1093/humrep/deq310. View

10.

Noguchi H, Iwase A, Iwasa T, Kanasaki H, Kimura F, Kugu K . Japan Society of Obstetrics and Gynecology revised diagnostic criteria for polycystic ovary syndrome: JSOG2024 criteria. J Obstet Gynaecol Res. 2024; 51(1):e16152. DOI: 10.1111/jog.16152. View

11.

Carmina E, Lobo R . Comparing Lean and Obese PCOS in Different PCOS Phenotypes: Evidence That the Body Weight Is More Important than the Rotterdam Phenotype in Influencing the Metabolic Status. Diagnostics (Basel). 2022; 12(10). PMC: 9600591. DOI: 10.3390/diagnostics12102313. View

12.

Kotlyar A, Seifer D . Ethnicity/Race and Age-Specific Variations of Serum AMH in Women-A Review. Front Endocrinol (Lausanne). 2021; 11:593216. PMC: 7900163. DOI: 10.3389/fendo.2020.593216. View

13.

Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R . Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2002; 26(7):883-96. DOI: 10.1038/sj.ijo.0801994. View

14.

Baba T . Polycystic ovary syndrome: Criteria, phenotypes, race and ethnicity. Reprod Med Biol. 2025; 24(1):e12630. PMC: 11751892. DOI: 10.1002/rmb2.12630. View

15.

Cheung L, Ma R, Lam P, Lok I, Haines C, So W . Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome. Hum Reprod. 2008; 23(6):1431-8. DOI: 10.1093/humrep/den090. View

16.

Hebbar M, Khalil H, Zia N, Sheikh J, Melson E, Davitadze M . Improving emotional and psychosexual well-being screening in women living with polycystic ovary syndrome: experiences from the United Kingdom and India. Endocr Connect. 2023; 12(11). PMC: 10563596. DOI: 10.1530/EC-23-0179. View

17.

Kim C, Lee S . Effectiveness of Lifestyle Modification in Polycystic Ovary Syndrome Patients with Obesity: A Systematic Review and Meta-Analysis. Life (Basel). 2022; 12(2). PMC: 8876590. DOI: 10.3390/life12020308. View

18.

Okoroh E, Hooper W, Atrash H, Yusuf H, Boulet S . Prevalence of polycystic ovary syndrome among the privately insured, United States, 2003-2008. Am J Obstet Gynecol. 2012; 207(4):299.e1-7. DOI: 10.1016/j.ajog.2012.07.023. View

19.

Muniyappa R, Sowers J . Role of insulin resistance in endothelial dysfunction. Rev Endocr Metab Disord. 2013; 14(1):5-12. PMC: 3594115. DOI: 10.1007/s11154-012-9229-1. View

20.

Cooney L, Dokras A . Beyond fertility: polycystic ovary syndrome and long-term health. Fertil Steril. 2018; 110(5):794-809. DOI: 10.1016/j.fertnstert.2018.08.021. View