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Jan Roar Mellembakken Division of Gynecology and Obstetrics, Department of Reproductive Medicine, Oslo University Hospital, Oslo, Norway

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Azita Mahmoudan Division of Gynecology and Obstetrics, Department of Reproductive Medicine, Oslo University Hospital, Oslo, Norway

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Lars Mørkrid Department of Medical Biochemistry, Oslo University Hospital, Rikshospitalet, Oslo, Norway

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Inger Sundström-Poromaa Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

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Laure Morin-Papunen Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, Finland

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Juha S Tapanainen Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, Finland
Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Uusimaa, Finland

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Terhi T Piltonen Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, Finland

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Angelica Lindén Hirschberg Department of Women’s and Children’s Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Stockholm, Sweden

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Elisabet Stener-Victorin Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden

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Eszter Vanky Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, UK
Department of Gynecology and Obstetrics, St. Olav’s Hospital, Trondheim, Norway

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Pernille Ravn Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark

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Richard Christian Jensen Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Marianne Skovsager Andersen Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Dorte Glintborg Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with a prevalence of 10–20% when the Rotterdam criteria are used ( 1 ). The PCOS diagnosis is based on at least two out of three

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Angelica Lindén Hirschberg Division of Obstetrics and Gynaecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.

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and the resulting FHA are probably the most common cause of amenorrhea among exercising women, not all sportswomen with menstrual disorders are hypometabolic. In fact, we have identified polycystic ovary syndrome (PCOS) as an alternative explanation

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Xiuhua Liao Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
Fujian Maternal-Fetal Clinical Medicine Research Center, Fuzhou, China
Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China

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Suqin Zhu Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Shumin Qiu Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Hua Cao Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Wenwen Jiang Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Huiling Xu Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Yan Sun Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

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Beihong Zheng Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
Fujian Maternal-Fetal Clinical Medicine Research Center, Fuzhou, China
Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China

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Introduction Polycystic ovary syndrome (PCOS) is one of the most prevalent reproductive endocrine disorders affecting women of reproductive age, with a prevalence of 5–10% ( 1 ). PCOS is characterized by pathological and physiological changes

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Dorte Glintborg Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Magda Lambaa Altinok Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Pernille Ravn Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark

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Kurt Bjerregaard Stage Department of Psychiatry, Odense University Hospital, Odense, Denmark

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Kurt Højlund Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Marianne Andersen Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Introduction Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by insulin resistance and hyperandrogenism ( 1 ). Central obesity is closely associated with insulin resistance and low-grade inflammation ( 2 ) and

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Feifei Cheng Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Noel Yat Hey Ng Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Claudia Ha Ting Tam Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Yuying Zhang Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Cadmon King Poo Lim Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Guozhi Jiang Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Alex Chi Wai Ng Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Tiffany Tse Ling Yau Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Lai Ping Cheung Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Aimin Xu Department of Medicine, Li Ka Shing (LKS) Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong, Hong Kong
Department of Pharmacy and Pharmacology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong

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Juliana C N Chan Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Centre in Diabetes Genomics and Precision Medicine, Hong Kong, Hong Kong

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Ronald C W Ma Department of Medicine and Therapeutics The Chinese University of Hong Kong, Hong Kong, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Centre in Diabetes Genomics and Precision Medicine, Hong Kong, Hong Kong

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Introduction Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age, affecting about 6–12% of the overall female population ( 1 ). A large community-based study in China reported a prevalence rate of 5

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Lina S Silva-Bermudez School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Freddy J K Toloza School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Maria C Perez-Matos School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Russell J de Souza Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada

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Laura Banfield Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada

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Andrea Vargas-Villanueva School of Medicine, Universidad de los Andes, Bogotá, Colombia

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Carlos O Mendivil School of Medicine, Universidad de los Andes, and Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia

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polycystic ovary syndrome. Outcome Subgroup N studies (participants) pMD (95% CI) I 2 P -value for difference between subgroups P -value for heterogeneity Cyproterone BMI PCOS 14 (306) −0.06 (−0.37, 0

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Signe Frøssing Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Malin Nylander Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Caroline Kistorp Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Sven O Skouby Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Jens Faber Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Introduction Women with polycystic ovary syndrome (PCOS) are challenged with a metabolic aspect of the syndrome as they have increased prevalence of overweight with central obesity and insulin resistance. They present with an accumulation of

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Ewa Stogowska Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland

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Karol Adam Kamiński Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland

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Bartosz Ziółko Techmo, Kraków, Poland

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Irina Kowalska Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland

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over the menstrual cycle, during hormonal replacement therapy or in postmenopausal women ( 1 , 10 , 11 , 12 , 13 ), there is a limited number of analysis concerning voice changes in reproductive disorders such as polycystic ovary syndrome (PCOS) or

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Teresa Vilariño-García Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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Antonio Pérez-Pérez Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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Esther Santamaría-López Valencian Infertility Institute (IVI), Seville, Spain

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Nicolás Prados Valencian Infertility Institute (IVI), Seville, Spain

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Manuel Fernández-Sánchez Valencian Infertility Institute (IVI), Seville, Spain

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Víctor Sánchez-Margalet Department of Medical Biochemistry, Molecular Biology and Immunology. Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain

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different cellular system. Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 5–10% of women at reproductive age ( 15 ). It has unknown origin and various clinical presentations during the life span. PCOS is characterized

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Ling Zhou Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Zhexin Ni Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Wen Cheng Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Jin Yu Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Shuai Sun Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Dongxia Zhai Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Chaoqin Yu Department of Gynecology of Traditional Chinese Medicine, Changhai Hospital, Naval Medical University, Shanghai, China

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Zailong Cai Department of Biochemistry and Molecular Biology, Naval Medical University, Shanghai, China

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Introduction Polycystic ovary syndrome (PCOS) is characterised by persistent anovulation, hyperandrogenism and insulin resistance (IR), involving a group of reproductive, endocrine and metabolic disorders. The pathophysiology of PCOS is

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