Polycystic Ovary Syndrome: Criteria, Phenotypes, Race and Ethnicity

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with diverse clinical manifestations influenced by genetic, environmental, and cultural factors. The Rotterdam 2003 criteria are widely used for diagnosis, accommodating a range of phenotypes. Racial and ethnic differences significantly affect PCOS symptoms, such as hyperandrogenism and hirsutism, with East Asian women showing lower hirsutism scores and South Asian, Middle Eastern, and Hispanic women showing higher scores. Metabolic features like obesity and insulin resistance vary by race, with South Asian, Hispanic, and Black women exhibiting higher insulin resistance. PCOS increases the risk of impaired glucose tolerance, type 2 diabetes, dyslipidemia, metabolic syndrome, and mental disorders, with prevalence and severity differing across races. Despite consistent PCOS prevalence across races, phenotypic differences necessitate race-specific diagnostic criteria, emphasizing the need for improved diagnostic methods and further research to address these disparities and mental health concerns.