Global Burden of Polycystic Ovary Syndrome: Socioeconomic Disparities, Reproductive Impacts, and Projections to 2050

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, affecting 11%-13% globally and representing a primary cause of anovulatory infertility, with substantial socioeconomic disparities influencing its worldwide burden. However, data on temporal trends, regional variations, and sociodemographic drivers of PCOS are limited. We aimed to evaluate global, regional, and national PCOS trends from 1990 to 2021 and project future impacts to 2050.

In this trend analysis based on the 2021 Global Burden of Diseases (GBD) study, we report on the prevalence, incidence, and years lived with disability (YLDs) rates per 100,000 individuals, as well as average annual percentage changes (AAPCs) for PCOS at the global, regional, and national levels. We analyzed these trends by age, SDI, and reproductive outcomes using age-period-cohort (APC) modelling, decomposition, inequality analysis, and Bayesian projections.

From 1990 to 2021, global PCOS prevalent cases increased from 36.65 million to 69.47 million (89.6% rise), with an age-standardised prevalence rate (ASPR) of 1757.8 per 100,000 in 2021 (AAPC 0.81 [95% CI 0.77-0.85]). High-middle SDI regions exhibited the highest burden (ASPR: 5237.6 per 100,000), while low-SDI regions showed the steepest rise (AAPC: 2.22). Infertility accounted for the majority of YLDs, peaking at ages 25-29. Socioeconomic inequalities decreased (Slope Index of Inequality from 28.55 to 22.28). Projections indicate 103.91 million cases by 2050.

From 1990 to 2021, global PCOS burden increased substantially, with marked socioeconomic and regional disparities. This underscores the need for enhanced screening, personalised treatments, and targeted interventions in low-SDI regions to promote reproductive health equity.