Functional and Structural Uterine Changes in PCOS

Area of Science:

• Reproductive endocrinology
• Gynecology
• Pathophysiology of PCOS

Background:

• Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder with complex causes.
• PCOS is linked to menstrual irregularities, androgen excess, and increased risks of metabolic and cardiovascular diseases.
• Understanding PCOS's impact on the uterus is crucial for reproductive health.

Purpose of the Study:

• To review structural and functional changes in the uterus associated with PCOS and hyperandrogenism.
• To synthesize current knowledge on uterine alterations in PCOS patients, models, and pregnancy.
• To identify gaps in research regarding the PCOS uterus.

Main Methods:

• Comprehensive literature search of PubMed, Medline, Embase, Google Scholar, and Cochrane Library (1964-2025).
• Inclusion of studies on the uterus in clinical PCOS, PCOS animal models, and pregnant PCOS patients.
• Narrative review synthesizing findings on uterine blood flow, morphology, and muscle thickness.

Main Results:

• Evidence suggests PCOS may affect uterine blood flow, morphology, and myometrial thickness.
• Potential functional impairment of the uterus in both pregnant and non-pregnant women with PCOS.
• Existing knowledge on uterine changes in PCOS is limited.

Conclusions:

• PCOS and associated hyperandrogenism may lead to structural and functional uterine alterations.
• Further research is essential to elucidate the precise impact of PCOS on uterine health.
• Future studies should investigate the relationship between PCOS, hyperandrogenism, and uterine morphology/function.