Objective: To address the limited diagnostic criteria, the lack of awareness, and poor management standards of polycystic ovarian syndrome (PCOS).
Key points:
1. Highlighting the significance and prevalence of PCOS.
2. Addressing the limited diagnostic criteria, lack of awareness, and poor management standards for this complex disorder.
3. Call for better and more reliable diagnostic criteria, awareness campaigns, and management guidelines to effectively cure this disease.
Conclusion: With unmitigated risk and significant prevalence globally, there is a great need to address this issue by developing proper diagnostic criteria, organizing awareness campaigns, and setting guidelines to address this disease effectively.

Polycystic ovarian syndrome (PCOS), Infertility, Rotterdam diagnostic criteria, Cardiovascular diseases, Anti-Mullerian hormone (AMH), Machine learning model, Public health burden, Diagnostic delay.

Polycystic ovarian syndrome (PCOS) is a complex, multidimensional endocrine disorder ‎found ‎in reproductive-aged women that leads to hormonal disturbance, raised androgen levels, irregular ‎periods, and infertility.[1] Currently, this disorder has emerged as one of the ‎leading health concerns due to its wider ‎prevalence, sedentary lifestyle, lack of awareness, and ‎poor diagnostic criteria. Therefore, ‎addressing this issue will benefit the ‎reproductive-aged female population and ‎increase the fertility rate worldwide. ‎

Prevalence
Globally, around 10% of reproductive-age women are affected by this complex health ailment.[2] This disorder is rapidly showing its wider prevalence in a region where there is a lack of awareness and limited management strategies, as illustrated in table 1.[2-4]

Table 1: Prevalence of PCOS by country/region

Risk factors
To date, there is no single identified cause of PCOS, but various factors, including genetic, environmental, and behavioral factors, have played a significant role in the pathophysiology of PCOS.[2]

Consequences
As a significant public health concern, PCOS not only causes infertility but also increases the risk of other endocrine system abnormalities, such as hirsutism, acne, impaired fasting glucose levels, glucose intolerance, and insulin resistance, which can lead to diabetes. Additionally, it increases the risk of cardiovascular disorders and develops different degrees of mental illness, such as anxiety disorders and depression. Moreover, if the disease remains untreated and persists for a long period, it may potentially develop into cancer of the female reproductive system.[5]

Diagnostic criteria
According to the World Health Organization (WHO), up to 70% of PCOS cases go undiagnosed due to a limited reliability and accuracy in diagnostic criteria.1 In the late 1990s, the National Institutes of Health (NIH) introduced the diagnostic criteria for PCOS, but due to inconsistency in proposed model, another criterion known as the Rotterdam Criteria was proposed in 2003 which requires at least 2 out of the 3 given features must be presents to confirm its diagnosis, such as oligo-anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovaries defined by the increased ovarian volume (>10 mL) or presence of 12 or more follicles in each ovary, as seen on ultrasound. Moreover, many studies also have been conducted regarding the diagnosis of PCOS; the implementation of Anti-Mullerian hormone (AMH), secreted by ovarian follicles which is a glycoprotein with the current diagnostic criteria, use of AMH along with other hormones such as steroids, testosterone, and use of a machine model in early detection of PCOS but all these methods and approaches are facing many challenges and limitations respectively. For this reason, there is a need for an appropriate method that will not only assist in the clinical diagnosis and minimize delays but will also play an important role in the management of the emotional and physiological symptoms of PCOS, which will benefit the health outcome.[1,5,6]

Management
In addition to diagnostic methods, the management of PCOS is complicated due to its multifactorial nature. However, lifestyle alteration, changes in dietary pattern, physical activity, and behavioural changes play a significant role in the management of PCOS.[7] However, despite some advancements in its management, the prevalence rate remains persistently high due to a lack of awareness, especially in underdeveloped countries, which leads to a notable health burden.[2]

Despite causing many reproductive and endocrine health problems in women, PCOS remains one of the leading health issues due to its wider prevalence, limited reliability and accuracy in diagnostic criteria, and lack of awareness among the people. To counter this syndrome, the Government, Health authorities such as the World Health Organization (WHO), and the National Institutes of Health (NIH) must make an appropriate diagnostic criterion and set up specific guidelines to deal with this condition effectively. It is also necessary to arrange awareness campaigns and screening programs, especially in developing countries, to educate people and promote a healthy lifestyle. Together, these approaches will significantly reduce the health burden with good outcomes.

The authors declare no acknowledgments.

The authors declare that there was no funding for this study.

Corresponding Author:
Puja
Independent Researcher, Northampton, United Kingdom
Email: pujamaheshwari341@gmail.com

Co-Authors:
Ajeet Raj
Department of General Internal Medicine
Northampton General Hospital NHS Trust, Northampton, United Kingdom

Karan Chaman Lal
Department of Medicine
Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan

Kainat Kousar
Department of Medicine
Bahria University Health Sciences (BUHS), Karachi, Pakistan

Conceptualization: Puja, Karan Chaman Lal. Original draft: Ajeet Raj, Karan Chaman Lal. Literature review: Puja. Writing—review and editing: Puja, Ajeet Raj, Karan Chaman Lal. Final approval of manuscript: Puja, Ajeet Raj, Karan Chaman Lal, Kainat Kousar.

Not applicable

The authors declare no conflict of interest.

None

https://doi.org/10.63096/medtigo3062329

Puja, Ajeet R, Karan CL, Kainat K. The Rising Burden of Polycystic Ovarian Syndrome (PCOS): A Call for Better Awareness and Diagnostic Standards. medtigo J Med. 2025;3(2):e3062329. doi:10.63096/medtigo3062329 Crossref