Abstract

Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-aged women, characterized by clinical manifestations such as hyperandrogenism, menstrual irregularities, and polycystic ovaries. Despite its prevalence and impact on women's health, the pathogenesis of PCOS remains incompletely understood. This review provides a comprehensive critical appraisal of existing literature on PCOS pathogenesis, addressing knowledge gaps and highlighting its multifactorial nature. A systematic literature review identified relevant articles published up to the knowledge cutoff date in 2023, focusing on molecular, genetic, hormonal, and environmental factors contributing to PCOS pathogenesis. Electronic databases, including PubMed, MEDLINE, and Embase, were systematically searched using predefined terms. Eligible studies investigated molecular, genetic, hormonal, and environmental factors associated with PCOS pathogenesis. The critical appraisal revealed diverse studies enriching our understanding of PCOS. Molecular and genetic studies highlighted alterations in signaling pathways, hormonal dysregulation, and the role of insulin resistance. Environmental factors, including lifestyle and exposure to endocrine-disrupting chemicals, were implicated. Heterogeneity in study designs and methodologies underscored the need for standardized approaches to enhance comparability. This review synthesizes current evidence on PCOS critical appraisal and pathogenesis, emphasizing its multifaceted nature. Standardization of study designs and methodologies will facilitate future comparisons, enabling the development of targeted therapeutic interventions and personalized management strategies for women affected by PCOS.

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