PCOS affects about 6% of women of reproductive age in the US and Europe using the 1990 National Institutes of Health criteria, 10% to 15% of women using the Androgen Excess and PCOS Society criteria, and 10% to 20% of women using the 2003 Rotterdam criteria.[7]Bozdag G, Mumusoglu S, Zengin D, et al. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016 Dec;31(12):2841-55.
http://www.ncbi.nlm.nih.gov/pubmed/27664216?tool=bestpractice.com
[8]Chiaffarino F, Cipriani S, Dalmartello M, et al. Prevalence of polycystic ovary syndrome in European countries and USA: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022 Dec;279:159-70.
http://www.ncbi.nlm.nih.gov/pubmed/36343588?tool=bestpractice.com
Similar rates are reported in China (10%) and Mexico (6%), suggesting the prevalence does not vary across ethnicities or different regions of the world.[9]Wu Q, Gao J, Bai D, et al. The prevalence of polycystic ovarian syndrome in Chinese women: a meta-analysis. Ann Palliat Med. 2021 Jan;10(1):74-87.
https://apm.amegroups.org/article/view/61035/html
http://www.ncbi.nlm.nih.gov/pubmed/33545750?tool=bestpractice.com
[10]Wolf WM, Wattick RA, Kinkade ON, et al. Geographical prevalence of polycystic ovary syndrome as determined by region and race/ethnicity. Int J Environ Res Public Health. 2018 Nov 20;15(11):2589.
https://www.mdpi.com/1660-4601/15/11/2589
http://www.ncbi.nlm.nih.gov/pubmed/30463276?tool=bestpractice.com
[11]Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016 Jul;106(1):6-15.
https://www.fertstert.org/article/S0015-0282(16)61232-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/27233760?tool=bestpractice.com
There do seem to be differences in the phenotype of PCOS within and between countries.[8]Chiaffarino F, Cipriani S, Dalmartello M, et al. Prevalence of polycystic ovary syndrome in European countries and USA: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022 Dec;279:159-70.
http://www.ncbi.nlm.nih.gov/pubmed/36343588?tool=bestpractice.com
[12]Joham AE, Norman RJ, Stener-Victorin E, et al. Polycystic ovary syndrome. Lancet Diabetes Endocrinol. 2022 Sep;10(9):668-80.
http://www.ncbi.nlm.nih.gov/pubmed/35934017?tool=bestpractice.com
For example, studies report greater impairments in glucoregulatory status in Hispanic compared with white women in the US, and lower rates of ovulatory PCOS in the US compared with Europe.[8]Chiaffarino F, Cipriani S, Dalmartello M, et al. Prevalence of polycystic ovary syndrome in European countries and USA: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022 Dec;279:159-70.
http://www.ncbi.nlm.nih.gov/pubmed/36343588?tool=bestpractice.com
[13]Kazemi M, Kim JY, Wan C, et al. Comprehensive evaluation of disparities in cardiometabolic and reproductive risk between Hispanic and White women with polycystic ovary syndrome in the United States: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022 Feb;226(2):187-204.e15.
http://www.ncbi.nlm.nih.gov/pubmed/34384776?tool=bestpractice.com
The reported frequency of hirsutism is lower in East Asia and higher among indigenous Australians.[7]Bozdag G, Mumusoglu S, Zengin D, et al. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016 Dec;31(12):2841-55.
http://www.ncbi.nlm.nih.gov/pubmed/27664216?tool=bestpractice.com
[11]Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016 Jul;106(1):6-15.
https://www.fertstert.org/article/S0015-0282(16)61232-3/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/27233760?tool=bestpractice.com
There have been no prospective studies that document incidence rates for PCOS.
PCOS accounts for 80% to 90% of cases of hyperandrogenism in women. In one large series of women presenting with androgen excess or ovulatory dysfunction, approximately 80% had PCOS, 3% had the hyperandrogenism-insulin resistance-acanthosis nigricans syndrome, 1.5% had 21-hydroxylase-deficient nonclassic adrenal hyperplasia, 0.6% had 21-hydroxylase-deficient classic adrenal hyperplasia, and 0.2% had androgen-secreting tumors.[14]Azziz R, Sanchez LA, Knochenhauer ES, et al. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab. 2004 Feb;89(2):453-62.
https://academic.oup.com/jcem/article/89/2/453/2840734
http://www.ncbi.nlm.nih.gov/pubmed/14764747?tool=bestpractice.com
Men in families with PCOS may have manifestations including excessive hairiness, premature male-pattern baldness, elevated levels of dehydroepiandrosterone sulfate, abnormal hormonal responses to dynamic testing, and aberrations in insulin sensitivity and secretion.[15]Sam S, Sung YA, Legro RS. Evidence for pancreatic beta-cell dysfunction in brothers of women with polycystic ovary syndrome. Metabolism. 2008 Jan;57(1):84-9.
http://www.ncbi.nlm.nih.gov/pubmed/18078863?tool=bestpractice.com
[16]Legro RS, Kunselman AR, Demers L, et al. Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2002 May;87(5):2134-8.
https://academic.oup.com/jcem/article/87/5/2134/2846926
http://www.ncbi.nlm.nih.gov/pubmed/11994353?tool=bestpractice.com