Global Burden and Future Trends of Polycystic Ovary Syndrome: Insights from the GBD 2021 Study

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, defined by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. It is associated with infertility, metabolic abnormalities, and an increased cardiovascular risk. This study provides an updated and comprehensive analysis of PCOS burden from 1990 to 2021 using the latest Global Burden of Disease (GBD) dataset, focusing on trends, regional disparities, and future projections.

Data on the prevalence, incidence, and disability-adjusted life years (DALYs) associated with PCOS were obtained from the GBD 2021. Temporal trends were evaluated using estimated annual percentage change (EAPC). Regional disparities were examined by stratifying data according to the socio-demographic index (SDI). Age-Period-Cohort (APC) modeling was employed to investigate disease dynamics across age groups and birth cohorts, while Bayesian Age-Period-Cohort (BAPC) models were utilized to project global burden trends through 2036.

In 2021, there were 65.8 million prevalent cases, 1.18 million incident cases, and 0.58 million DALYs due to PCOS globally. Middle SDI regions showed the highest growth rates in prevalence (EAPC 1.73%), incidence (EAPC 1.39%), and DALYs (EAPC 1.72%). Adolescents aged 15-19 demonstrated the highest incidence rates, while the peak prevalence shifted to women aged 30-34. High SDI regions had the highest age-standardized rates (ASRs), whereas Southeast Asia exhibited the most rapid growth. BAPC models forecast continued increases in PCOS burden, with prevalence projected to reach 77.87 million by 2036, though the age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) are expected to decline.

PCOS represents an urgent global health challenge, with rising burdens, especially in middle-income regions. Targeted and equitable interventions are essential to improve early diagnosis, raise public awareness, and mitigate long-term health and socioeconomic consequences.