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. 2023 Dec 13;14:1273542. doi: 10.3389/fendo.2023.1273542

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Copyright © 2023 Wang, Li and Chen

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The major clinical manifestations of PCOS. These symptoms can be divided into four categories: reproductive, endocrine, metabolic, and psychological comorbidities. (1) Reproductive features: the dysregulated hypothalamus-pituitary-gonadal (HPG) axis and neuroendocrine factors contribute to menstrual irregularities, anovulation, infertility, and increased risks of pregnancy complications. (2) Endocrine features: hormonal imbalances (ovarian and adrenal hyperandrogenemia). Symptoms like hirsutism, acne, and androgenic alopecia are induced by high levels of circulating androgens. (3) Metabolic features: 30% of lean and 70% of obese patients exhibit insulin resistance. Additionally, women with PCOS suffer from abdominal obesity, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD). These metabolic abnormalities can result in long-term cardiometabolic sequelae, including type 2 diabetes, hypertension, and atherosclerotic disease. (4) Psychological features: PCOS is associated with an increased prevalence of depression, anxiety, and poor quality of life. Created with BioRender.com.