Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
Polycystic ovary syndrome (PCOS) is a complex, chronic, and under-recognized disorder. Diagnosis experience may have lasting effects on well-being and self-management.
Objective
To investigate PCOS diagnosis experiences, information provided, and concerns about PCOS.
Design
Cross-sectional study using an online questionnaire.
Setting
Recruitment via support group web sites in 2015 to 2016.
Participants
There were 1385 women with a reported diagnosis of PCOS who were living in North America (53.0%), Europe (42.2%), or other world regions (4.9%); of these, 64.8% were 18 to 35 years of age.
Main Outcome Measures
Satisfaction with PCOS diagnosis experience, satisfaction with PCOS information received at the time of diagnosis, and current concerns about PCOS.
Results
One-third or more of women reported >2 years (33.6%) and ≥3 health professionals (47.1%) before a diagnosis was established. Few were satisfied with their diagnosis experience (35.2%) or with the information they received (15.6%). Satisfaction with information received was positively associated with diagnosis satisfaction [odds ratio (OR), 7.0; 95% confidence interval (CI), 4.9 to 9.9]; seeing ≥5 health professionals (OR, 0.5; 95% CI, 0.3 to 0.8) and longer time to diagnosis (>2 years; OR, 0.4; 95% CI, 0.3 to 0.6) were negatively associated with diagnosis satisfaction (independent of time since diagnosis, age, and world region). Women's most common concerns were difficulty losing weight (53.6%), irregular menstrual cycles (50.8%), and infertility (44.5%).
Conclusions
In the largest study of PCOS diagnosis experiences, many women reported delayed diagnosis and inadequate information. These gaps in early diagnosis, education, and support are clear opportunities for improving patient experience.
PMID 27906550 27906550 DOI 10.1210/jc.2016-2963 10.1210/jc.2016-2963
Cite this article
Gibson-Helm, M., Teede, H., Dunaif, A., & Dokras, A. (2017). Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism, 102(2), 604-612. https://doi.org/10.1210/jc.2016-2963
Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017;102(2):604-612. doi:10.1210/jc.2016-2963
Gibson-Helm, M., et al. "Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome." The Journal of clinical endocrinology and metabolism, vol. 102, no. 2, 2017, pp. 604-612.
Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS) in women with irregular menses, yet the relationship between androgens and ovarian dysfunction remains poorly understood in eumenorrheic women. The objective of the study was to evaluate whether sporadic anovulation was associated with higher T and anti-müllerian hormone (AMH; marker of ovarian follicle count) concentrations in eumenorrheic women.
This was a prospective cohort study from 2005 to 2007.
The study was conducted at the University of Buffalo in western New York state. A total of 259 eumenorrheic women without a self-reported history of infertility, PCOS, or other endocrine disorder participated in the study. Total T and AMH were measured five to eight times per cycle for one (n = 9) or two (n = 250) cycles per woman (n = 509 cycles) with timing of menstrual cycle phase assisted by fertility monitors. Anovulatory cycles were defined biochemically by progesterone and LH concentrations. Repeated-measures ANOVA was conducted on log-transformed data with adjustment for age. Compared with ovulatory cycles (n = 467), sporadic anovulatory cycles (n = 42) had marginally higher total and significantly higher free T [mean 23.7 ng/dL (95% confidence interval [CI] 21.4-26.3) vs 21.6 ng/dL (95% CI 20.9-22.3), P = .08, and 0.36 ng/dL (95% CI 0.33-0.40) vs 0.32 ng/dL (95% CI 0.31-0.33), P = .02, respectively] during menses and also throughout the luteal phase (P < .01 for all). Women with higher T had elevated AMH concentrations, increased reporting of a history of acne requiring medical treatment, but not increased hirsutism. Mechanisms of androgen-related ovulatory dysfunction that characterize PCOS in women with menstrual disturbances may occur across a continuum of T concentrations, including in eumenorrheic women without clinical hyperandrogenism.
Curcumin, a bioactive polyphenol derived from turmeric (Curcuma longa), has garnered substantial attention for its potent anti-inflammatory, antioxidant, and antineoplastic properties. This review explores the therapeutic potential of curcumin in gynecologic health, with a focus on its role in the management of ovarian, cervical, and endometrial cancers, as well as benign conditions such as endometriosis, polycystic ovary syndrome, premenstrual syndrome, and menopausal symptoms. A literature review was conducted on the health effects of gynecology. Relevant articles were identified through systematic searches in major biomedical databases, including PubMed, Scopus, Cochrane Library, Embase, and Web of Science databases for studies reporting the relationship between curcumin and some in gynecological diseasess as of 2025. Curcumin modulates key inflammatory signaling pathways, reduces oxidative stress, and exerts antiproliferative effects, making it a promising adjunct in the treatment of both neoplastic and inflammatory gynecologic disorders. Nevertheless, clinical translation remains limited by challenges such as poor bioavailability and a paucity of large-scale, randomized controlled trials. Emerging evidence supports the integration of curcumin into multimodal treatment strategies, particularly in oncology and chronic inflammatory conditions. In light of the need to improve treatment efficacy and enhance patients' quality of life, the exploration of novel adjuvant therapeutic strategies is highly warranted. Recent studies have demonstrated the beneficial effects of curcumin and its novel analogues across a range of gynecologic diseases, while advances in formulation technologies have led to improved pharmacokinetic profiles and therapeutic outcomes. Nevertheless, further robust clinical investigations are required to optimize curcumin formulations, enhance bioavailability, and establish evidence-based guidelines for its integration into gynecologic care. This review synthesizes current evidence and highlights the underlying molecular mechanisms responsible for the observed effects, aiming to support the rational development of curcumin-based strategies in gynecology.
Social Egg Freezing (SEF), often promoted in Western contexts as a means to enhance reproductive autonomy, has seen varied uptake in countries with wider gender disparities. In such settings, where reproductive decisions are shaped by strong societal norms, SEF raises ethical concerns about whether it enables autonomy or reinforces prevailing expectations. This study examines how SEF is framed and regulated in countries ranking in the lowest quintile of the 2024 Gender Gap Index (GGI), where reproductive autonomy is emergent and SEF is increasingly promoted as a demographic intervention. A scoping review was conducted on SEF literature published between 2013 and 2025 across 29 countries in the lowest GGI quintile. English-language sources were retrieved from PubMed, while Japanese (J-Stage, Ichushi-web) and Arabic (Arabase [al-manẓūma], E-Marefa) were searched. Supplementary materials-including government policies, religious texts, and professional guidelines-were identified through Google Advanced Search, manual screening, and documents from the International Islamic Fiqh Academy (IIFA). Eligible sources included empirical and normative publications addressing SEF in the countries under review. Three reviewers screened and extracted data. Themes were developed iteratively. Sixty-eight sources met inclusion criteria and were (1) awareness and education; (2) sociocultural and religious values; (3) policy and legal frameworks; (4) clinical practices and outcomes; and (5) commercialization and autonomy. Most sources (73.9%) focused on themes (2)-(4), while awareness (12.2%) and commercialization (13.9%) received limited attention. In most Muslim-majority countries reviewed, religious frameworks restricted SEF to married women. Turkey is a notable exception, permitting SEF for single women though embryo transfer requires marriage. Only 23 of the 68 sources were empirical, and just four employed qualitative methods. Although SEF is often framed as empowering, this promise is context-dependent and frequently illusory. Cultural and structural constraints shape women's choices, limiting the autonomy SEF claims to offer. Rather than imposing hegemonic neo-liberal assumptions, future policy and research should engage with local moral reasoning while examining how norms may reinforce inequality. Empirical studies are urgently needed to illuminate lived realities and improve policy development.
The primary objective of polycystic ovarian syndrome (PCOS) treatment is to achieve mono-ovulatory cycles, thereby enabling pregnancy and childbirth. Laparoscopic ovarian drilling (LOD) and transvaginal ovarian drilling (TVOD) are widely used second-line treatments for ovulation induction in PCOS patients who do not respond to clomiphene citrate (CC). LOD involves the application of heat or laser energy to create small perforations in the ovary, whereas TVOD involves ultrasound-guided ovarian puncture. Both LOD and TVOD have been shown to be effective in promoting ovulation and enhancing fertility outcomes in PCOS patients. TVOD offers several potential advantages over LOD, including a lower risk of surgical complications, reduced cost, and the ability to be performed in an outpatient setting. Both LOD and TVOD are effective treatment options for PCOS-related infertility. The choice between the two procedures should be based on individual patient characteristics, including body mass index (BMI), hormonal profiles, and previous responses to treatment. Further research is needed to optimize these techniques and clarify their clinical applications. Patients with clomiphene-resistant PCOS should be carefully assessed for both LOD and TVOD. LOD may be more suitable for patients with elevated luteinizing hormone (LH) levels and shorter durations of infertility. In contrast, TVOD may be preferred for patients who would benefit from a less invasive approach with a lower risk of adhesion formation.