Introduction: PCOS is a common endocrine disorder with a diverse range of metabolic, reproductive and psychological features. Although considered a dynamic condition, little is understood about how this condition progresses across the life course. In particular, it is unclear whether the endocrine and metabolic abnormalities associated with PCOS worsen in women as they age, particularly after menopause. We undertook a systematic review of observational studies of women with PCOS aged 45 years or more, to examine the range and severity of symptoms in women in the peri and post-menopausal period.
Methods: We searched the following databases until 31st May 2018: Pubmed, Psychinfo, Embase, and CiNAHL. Studies that examined any aspect of PCOS (variously diagnosed) in women aged 45 years or more were eligible for inclusion. Two review authors are currently independently extracting data and assessing study quality using the Newcastle-Ottawa Scale. Results will be synthesized by study type and broad category of endocrine, metabolic and psychosocial parameters will be examined. Where possible, meta-analyses will be undertaken to estimate pooled effects for outcomes of interest.
Results: We identified 3156 articles from the searches, and of these 1593 were excluded based on title alone. The remaining 1563 studies are currently being assessed for eligibility; data extraction and quality assessment are ongoing. Results will be presented with a focus on synthesising the evidence about age at menopause and severity of menopausal symptoms; degree of ovarian dysfunction, hyperandrogenism and psychosocial complications; and the extent of co-morbidities (e.g. cardiovascular disease, diabetes, cancer, depression etc.) as women age.
Conclusion: This review will present the current state of evidence regarding the expression of PCOS as women age. This will help to clarify the postmenopausal phenotype of PCOS, and provide directions for strategies to improve diagnosis and management of this condition in later life.