Semin Reprod Med 2021; 39(03/04): 078-093
DOI: 10.1055/s-0041-1730021
Review Article

The Prevalence of Clinical Characteristics of Polycystic Ovary Syndrome among Indigenous Women: A Systematic Search and Review of the Literature

Emily Gilbert
1   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
,
Jodie Avery
2   Adelaide Medical School, The University of Adelaide, South Australia, Australia
,
Rebeccah Bartlett
1   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
,
Sandra Campbell
3   Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Queensland, Australia
,
Anju Joham
1   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
,
Alice Rumbold
4   South Australian Health and Medical Research Institute, South Australia, Australia
,
Jacqueline Boyle
1   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
› Author Affiliations
Funding This research received no external funding.

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women; however, to date there has been no synthesis of the burden of PCOS specifically among indigenous women. We aimed to systematically identify and collate studies reporting prevalence and clinical features of PCOS among indigenous women worldwide. We performed a comprehensive search of six databases (Ovid MEDLINE, MEDLINE In Process & Other Non-Indexed Citations, EMBASE, EBM reviews, CINAHL, and SCOPUS) supplemented by gray literature searches and the screening of reference lists. A narrative synthesis was conducted. Fourteen studies met inclusion criteria; however, one was excluded as it assessed only children and adolescents younger than 15 years, with limited clinical relevance. Studies examined indigenous women from Australia, Sri Lanka, New Zealand, and the United States. Prevalence of PCOS was reported in only four studies and ranged from 3.05% for women in Sri Lanka to 26% for women in Australia. All included studies reported on at least one clinical feature of PCOS. Of the studies that reported on a comparison group from the same country, there was evidence of more severe features in indigenous women from New Zealand and the United States. The limited evidence available warrants further investigation of the burden of PCOS in indigenous women to build the knowledge base for effective and culturally relevant management of this condition.

Authors' Contributions

Conceptualization: E.G., S.C., A.R., and J.B.; data curation: E.G. and J.A.; formal analysis: E.G., J.A., and R.B.; investigation: E.G., J.A., and J.B.; methodology: A.R. and J.B.; supervision: S.C., A.R., and J.B.; writing—original draft: E.G. and J.B.; writing—reviewing and editing: E.G., J.A., R.B., S.C., A.J., A.R., and J.B.


Supplementary Material



Publication History

Article published online:
17 July 2021

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  • References

  • 1 Azziz R, Carmina E, Chen Z. et al. Polycystic ovary syndrome. Nat Rev Dis Primers 2016; 2: 16057
  • 2 Macut D, Bjekić-Macut J, Rahelić D, Doknić M. Insulin and the polycystic ovary syndrome. Diabetes Res Clin Pract 2017; 130: 163-170
  • 3 Teede HJ, Misso ML, Boyle JA. et al; International PCOS Network. Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Med J Aust 2018; 209 (S7): S3-S8
  • 4 Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynaecol 2010; 31 (01) 24-31
  • 5 Zhao Y, Qiao J. Ethnic differences in the phenotypic expression of polycystic ovary syndrome. Steroids 2013; 78 (08) 755-760
  • 6 Moran C, Arriaga M, Arechavaleta-Velasco F, Moran S. Adrenal androgen excess and body mass index in polycystic ovary syndrome. J Clin Endocrinol Metab 2015; 100 (03) 942-950
  • 7 Legro RS, Strauss JF. Molecular progress in infertility: polycystic ovary syndrome. Fertil Steril 2002; 78 (03) 569-576
  • 8 March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010; 25 (02) 544-551
  • 9 Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016; 31 (12) 2841-2855
  • 10 Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003; 163 (04) 427-436
  • 11 Bajaj M, Banerji MA. Type 2 diabetes in South Asians: a pathophysiologic focus on the Asian-Indian epidemic. Curr Diab Rep 2004; 4 (03) 213-218
  • 12 Pandit K, Goswami S, Ghosh S, Mukhopadhyay P, Chowdhury S. Metabolic syndrome in South Asians. Indian J Endocrinol Metab 2012; 16 (01) 44-55
  • 13 Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol 2011; 24 (04) 223-227
  • 14 Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian J Endocrinol Metab 2014; 18 (03) 317-324
  • 15 Dadachanji R, Shaikh N, Mukherjee S. Genetic variants associated with hyperandrogenemia in PCOS pathophysiology. Genet Res Int 2018; 2018: 7624932
  • 16 Louwers YV, Stolk L, Uitterlinden AG, Laven JS. Cross-ethnic meta-analysis of genetic variants for polycystic ovary syndrome. J Clin Endocrinol Metab 2013; 98 (12) E2006-E2012
  • 17 The World Bank. Indigenous peoples. Accessed August 12, 2020 at: https://www.worldbank.org/en/topic/indigenouspeoples
  • 18 Anderson I, Robson B, Connolly M. et al. Indigenous and tribal peoples' health (the Lancet-Lowitja Institute Global Collaboration): a population study. Lancet 2016; 388 (10040): 131-157
  • 19 Paradies Y. Colonisation, racism and indigenous health. J Popul Res 2016; 33 (01) 83-96
  • 20 Kirmayer LJ, Brass G. Addressing global health disparities among Indigenous peoples. Lancet 2016; 388 (10040): 105-106
  • 21 Valery PC, Moloney A, Cotterill A, Harris M, Sinha AK, Green AC. Prevalence of obesity and metabolic syndrome in Indigenous Australian youths. Obes Rev 2009; 10 (03) 255-261
  • 22 Turin TC, Saad N, Jun M. et al. Lifetime risk of diabetes among First Nations and non-First Nations people. CMAJ 2016; 188 (16) 1147-1153
  • 23 Moher D, Shamseer L, Clarke M. et al; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4 (01) 1
  • 24 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81 (01) 19-25
  • 25 Wells G, Shea B, O'Connell D. et al. The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. Clin Epidemiol 2000
  • 26 Higgins JPT, Altman DG, Gøtzsche PC. et al; Cochrane Bias Methods Group, Cochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928
  • 27 Afifi L, Saeed L, Pasch LA. et al. Association of ethnicity, Fitzpatrick skin type, and hirsutism: a retrospective cross-sectional study of women with polycystic ovarian syndrome. Int J Womens Dermatol 2017; 3 (01) 37-43
  • 28 Boyle JA, Cunningham J, Norman RJ, Dunbar T, O'Dea K. Polycystic ovary syndrome and metabolic syndrome in Indigenous Australian women. Intern Med J 2015; 45 (12) 1247-1254
  • 29 Boyle JA, Cunningham J, O'Dea K, Dunbar T, Norman RJ. Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia. Med J Aust 2012; 196 (01) 62-66
  • 30 Davis SR, Knight S, White V, Claridge C, Davis BJ, Bell R. Preliminary indication of a high prevalence of polycystic ovary syndrome in indigenous Australian women. Gynecol Endocrinol 2002; 16 (06) 443-446
  • 31 Purifoy FE, Koopmans LH, Tatum RW, Mayes DM. Serum androgens and sex hormone binding globulin in obese Pima Indian females. Am J Phys Anthropol 1981; 55 (04) 491-496
  • 32 Roumain J, Charles MA, de Courten MP. et al. The relationship of menstrual irregularity to type 2 diabetes in Pima Indian women. Diabetes Care 1998; 21 (03) 346-349
  • 33 Wijeyaratne CN, Seneviratne RdeA, Dahanayake S. et al. Phenotype and metabolic profile of South Asian women with polycystic ovary syndrome (PCOS): results of a large database from a specialist Endocrine Clinic. Hum Reprod 2011; 26 (01) 202-213
  • 34 Williamson K, Gunn AJ, Johnson N, Milsom SR. The impact of ethnicity on the presentation of polycystic ovarian syndrome. Aust N Z J Obstet Gynaecol 2001; 41 (02) 202-206
  • 35 Weiss DJ, Charles MA, Dunaif A. et al. Hyperinsulinemia is associated with menstrual irregularity and altered serum androgens in Pima Indian women. Metabolism 1994; 43 (07) 803-807
  • 36 Wijeyaratne CN, Waduge R, Arandara D. et al. Metabolic and polycystic ovary syndromes in indigenous South Asian women with previous gestational diabetes mellitus. BJOG 2006; 113 (10) 1182-1187
  • 37 Ellis E, Gibson-Helm M, Boyle JA. Polycystic ovary syndrome in Central Australia: diagnosis and screening of cardiometabolic risk and emotional wellbeing. Aust J Gen Pract 2018; 47 (04) 227-232
  • 38 Legro RS, Myers ER, Barnhart HX. et al; Reproductive Medicine Network. The Pregnancy in polycystic ovary syndrome study: baseline characteristics of the randomized cohort including racial effects. Fertil Steril 2006; 86 (04) 914-933
  • 39 Boyle J, Hollands G, Beck S. et al. Process evaluation of a pilot evidence-based Polycystic Ovary Syndrome clinic in the Torres Strait. Aust J Rural Health 2017; 25 (03) 175-181
  • 40 Ministry of Health. Wai 2575 Māori Health Trends Report. Wellington: Ministry of Health; 2019
  • 41 Kumarapeli V, Seneviratne RdeA, Wijeyaratne CN, Yapa RM, Dodampahala SH. A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semi-urban population in Sri Lanka. Am J Epidemiol 2008; 168 (03) 321-328
  • 42 Hjort L, Novakovic B, Grunnet LG. et al. Diabetes in pregnancy and epigenetic mechanisms-how the first 9 months from conception might affect the child's epigenome and later risk of disease. Lancet Diabetes Endocrinol 2019; 7 (10) 796-806
  • 43 Gentles D, Metcalf P, Dyall L. et al. Metabolic syndrome prevalence in a multicultural population in Auckland, New Zealand. N Z Med J 2007; 120 (1248): U2399
  • 44 Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80 (04) 1429-1430
  • 45 Escobar-Morreale HF, Carmina E, Dewailly D. et al. Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update 2012; 18 (02) 146-170
  • 46 Tremblay MS, Pérez CE, Ardern CI, Bryan SN, Katzmarzyk PT. Obesity, overweight and ethnicity. Health Rep 2005; 16 (04) 23-34
  • 47 Davy C, Harfield S, McArthur A, Munn Z, Brown A. Access to primary health care services for Indigenous peoples: a framework synthesis. Int J Equity Health 2016; 15 (01) 163
  • 48 Marrone S. Understanding barriers to health care: a review of disparities in health care services among indigenous populations. Int J Circumpolar Health 2007; 66 (03) 188-198
  • 49 Harris SB, Tompkins JW, TeHiwi B. Call to action: a new path for improving diabetes care for Indigenous peoples, a global review. Diabetes Res Clin Pract 2017; 123: 120-133