Health Outcomes in Postmenopausal Women with Polycystic Ovary Syndrome History: Systematic review and meta-analysis

Backgrounds: Polycystic ovary syndrome (PCOS) is one of the most common reproductive and endocrine diseases that can impact a woman's health status throughout her life. Concerns have always been focused on women at adolescent or reproductive age, however the outcomes of PCOS occurring at their postmenopausal age have not been clarified. Methods: We conducted this systematic review and meta-analysis to identify the association between health outcomes of postmenopausal women and their experiences of PCOS. The relevant literature was searched from Embase databases, Cochrane Library and PubMed. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). The weighted mean differences (WMDs) and their 95% confidence intervals (CIs) of relevant health parameters were calculated between postmenopausal women with PCOS history and the healthy controls. Pooled odds ratio (OR) was used to evaluate the association between PCOS and specific health outcome. Results: Our study included 15 studies with 757 postmenopausal women with history of PCOS and 4211 controls. Compared to the controls, the following parameters were significantly higher among postmenopausal women with PCOS history: body mass index (BMI) (WMD = 3.28, 95%CI: 1.24 to 5.31, I 2  = 96%, P  = 0.002), waist circumference (WMD = 7.01, 95%CI: 3.24 to 10.78, I 2  = 76%, P  < 0.001), waist/hip ratio (WHR) (WMD = 0.03, 95%CI: 0.00 to 0.06, I 2  = 93%, P  = 0.030), triglycerides (WMD = 0.40, 95%CI: 0.04 to 0.77, I 2  = 75%, P  = 0.030), total testosterone (WMD = 0.16, 95%CI: 0.09 to 0.22, I 2  = 51%, P  < 0.001) and free androgen index (FAI) (WMD = 1.82, 95%CI: 1.05 to 2.59, I 2  = 91%, P  < 0.001). In addition, PCOS history was significantly associated with the outc o mes of type 2 diabetes (OR = 4.09, 95%CI: 1.62 to 10.33, I 2  = 72%, P  = 0.003) and metabolic syndrome (OR = 3.93, 95%CI: 1.17 to 13.22, I 2  = 67%, P  = 0.030). Conclusions: This study illustrated that women exposed to PCOS might have higher risk of health problems at their postmenopausal age. Our findings shed light on requirement of early intervention among women with PCOS, as well as targeted health supports to postmenopausal women who have a history of PCOS.