Prevalence of polycystic ovary syndrome in European countries and USA: A systematic review and meta-analysis

Published:October 28, 2022DOI:


      • PCOS prevalence is similar in Europe and the USA, two areas with similar availability of gynaecological health services.
      • A major interest of this study was the analysis of four PCOS phenotypes frequency in countries of the same geographic area.
      • The prevalence of phenotype A, complete PCOS, was higher and that of C, ovulatory PCOS, was lower in the USA than in Europe.


      We conducted a systematic review and meta-analyses of the prevalence of Polycystic Ovary Syndrome (PCOS) and the frequency of its phenotypes in Europe and the USA, also focusing on temporal trends of the condition, to compare the PCOS prevalence among populations with a similar level of diagnostic resources availability and attitudes toward health problems, to improve comparability of estimates. We considered Europe and USA, two high-income areas with these characteristics.
      The overall PCOS prevalence according to the NIH1990, ESHRE/ASRM 2003, AES-PCOS diagnostic criteria was respectively 6.2 % (95%CI 5.3–7.0), 19.5 % (95%CI 17.3–21.6), and 15.0 % (95%CI 12.9–17.1), with no appreciable heterogeneity across geographic areas. Phenotype A, the “complete PCOS”, showed higher prevalence in all areas (44.8%, 95%CI 40.3–49.3), followed by phenotype D, called “non-hyperandrogenic PCOS” (19.5%), phenotype C termed as “ovulatory PCOS” (16.2%), and phenotype B, presenting as phenotype A but without polycystic ovarian morphology (14.9%). In all the studies analysing temporal trends of PCOS, an increase in prevalence of PCOS was reported, due, at least in part, to changing diagnostic criteria.
      The prevalence of PCOS is similar in European countries and the USA. Interestingly, some differences in the frequency of PCOS phenotypes emerged between the two areas with a higher frequency of phenotype A and a lower one of phenotype C in the USA. Recognizing the factors which explain these differences would lead to a better understanding of the etiopathogenesis and the clinical expression of PCOS.


      PCOS (Polycystic ovary syndrome), NIH (National Institutes of Health), ESHRE (European Society of Human Reproduction and Embryology), ASRM (American Society for Reproductive Medicine), AES (Androgen Excess Society), PCOM (polycystic ovarian morphology)


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