Lifestyle Factors and Sonographic Characteristics in PCOS: A Systematic Review

Abstract

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine and reproductive disorders affecting women of reproductive age worldwide (8, 9, 10). It is a heterogeneous condition characterized by reproductive, metabolic, and hormonal abnormalities, including ovulatory dysfunction, hyperandrogenism, insulin resistance, and polycystic ovarian morphology (1, 2, 10). According to the Rotterdam criteria, PCOS is diagnosed when at least two of the following features are present: oligo/anovulation, hyperandrogenism, and polycystic ovaries on ultrasound after excluding other endocrine disorders .The prevalence of PCOS has been reported to reach approximately 13% among reproductive-aged women depending on the diagnostic criteria used (9, 10). PCOS is clinically important because it adversely affects fertility, metabolic health, and quality of life and is associated with obesity, insulin resistance, dyslipidaemia, type 2 diabetes mellitus, cardiovascular disease, anxiety, and depression (3, 4, 9)

Women with PCOS commonly present with menstrual irregularities, oligomenorrhea, amenorrhea, chronic anovulation, and infertility. Hyperandrogenism is a hallmark feature and may present as hirsutism, acne, androgenic alopecia, and elevated serum androgen levels (7,9,10). Obesity and insulin resistance frequently coexist with PCOS and contribute to worsening hormonal imbalance and reproductive dysfunction . Several studies reported that obesity, hyperinsulinaemia, dyslipidaemia, and altered adipokine production contribute to disrupted folliculogenesis, follicular arrest, and reduced fertility (2, 8, 9). Psychological manifestations such as anxiety, depression, poor body image, and reduced quality of life are also frequently reported among women with PCOS (4, 9, 10).