Solomon, C. G. (1999). The epidemiology of polycystic ovary syndrome. Prevalence and associated disease risks. Endocrinology and Metabolism Clinics of North America, 28(2), 247-263. https://doi.org/10.1016/s0889-8529(05)70069-4
Solomon CG. The epidemiology of polycystic ovary syndrome. Prevalence and associated disease risks. Endocrinol Metab Clin North Am. 1999;28(2):247-263. doi:10.1016/s0889-8529(05)70069-4
Solomon, Caren G. "The epidemiology of polycystic ovary syndrome. Prevalence and associated disease risks." Endocrinology and Metabolism Clinics of North America, vol. 28, no. 2, 1999, pp. 247-263.
PCOS affects about 5% of women and is linked to diabetes risk
A 1999 review reports that among women of reproductive age, about 5% have polycystic ovary syndrome (PCOS). The estimate uses a definition of missing ovulation and excess androgens. The condition is now also called PMOS (polyendocrine metabolic ovarian syndrome). Available data support higher rates of type 2 diabetes and endometrial cancer in PMOS / PCOS.
About 3 in 10 women with PCOS aged 14 to 44 had impaired glucose tolerance. Source: Solomon CG, 1999, PMID 10352918.Study at a glance, 1999 review of 277 women in Alabama: PCOS affects about 5% of women and is linked to diabetes risk. Source: Solomon CG, 1999, PMID 10352918.
Key Findings
A population-based study of 277 women in Alabama, which the review calls its best estimate, put PCOS prevalence at 4.6%, within a possible range of 3.5% to 11.2%.
Ultrasound found polycystic ovaries in 21% to 22% of randomly selected women, and the review notes that many women with polycystic ovaries are endocrinologically normal.
Among 249 women with PCOS aged 14 to 44 years, 31% had impaired glucose tolerance and 7% had type 2 diabetes, significantly higher than in normally cycling controls.
In a Mayo Clinic cohort of 1270 women with chronic lack of ovulation and PCOS-like ovaries, relative risk of later endometrial cancer was 3.1 versus population rates (95% CI, 1.1 to 7.3).
In a retrospective cohort of 786 women with PCOS, deaths from all circulatory disease before age 75 were not increased (standardized mortality ratio, 0.83; 95% CI, 0.46 to 1.37).
Interpretation
This 1999 review examined PCOS / PMOS disease risk across published studies. Diabetes and endometrial cancer were more common in women with the condition. Heart disease risk factors were more common too, but heart disease itself was not. Larger, multi-year studies that account for weight would add to this picture.
RRM Context
The review reports links between PMOS / PCOS and long-term metabolic and endometrial disease. Restorative reproductive medicine looks for the cause of an irregular or missing ovulatory cycle. The review's list of linked risks takes that question beyond fertility. A full look at the menstrual cycle can reveal this wider pattern early, beyond fertility alone. In 2026 an international consensus renamed the condition. The new name points to its hormone, metabolic, and ovary features. That broader view fits how restorative care treats the cycle as a sign of overall health.
Our editorial summary of this paper, not the article's abstract.
Abstract
Polycystic ovary syndrome is a common problem affecting approximately 5% of women of reproductive age when defined by clinical features of anovulation and hyperandrogenism. Metabolic derangements associated with this condition may predispose to a range of diseases with attendant morbidity and mortality risks. In general, available data support significantly increased rates of type II diabetes mellitus, dyslipidemia, and endometrial cancer in PCOS that are not completely explained by obesity; data also suggest that rates of hypertension, gestational diabetes, and pregnancy-induced hypertension may likewise be increased, although the extent to which obesity mediates these risks is not clear. The increased prevalence of several cardiovascular risk factors in PCOS and limited cross-sectional data suggest that cardiovascular disease should be more likely in PCOS, but prospective data are lacking to confirm this supposition. Limited data have suggested an association between PCOS and ovarian cancer risk and require further study. The present data do not support an increased risk for breast cancer in this condition. Long-term prospective data are clearly needed to better delineate the nature and magnitude of disease risks associated with PCOS, with appropriate adjustment for associated obesity. Such information is a necessary background for understanding the role of established and emerging PCOS therapies, including oral contraceptives, intermittent progesterone, ovulation induction agents, and insulin sensitizers, in modifying such risks. In the meantime, close follow-up of women with PCOS and encouragement of lifestyle practices likely to reduce disease risks, such as regular exercise and weight control, should be standard practice.
PMOS / PCOS has four diagnostic phenotypes and distinct metabolic, reproductive, and mental health implications. How RRM-trained clinicians approach diagnosis and treatment differently.
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