Abstract
BackgroundPolycystic ovary syndrome (PCOS) is a complex and multi-faceted endocrine disorder that affects 5–20% of women. Literature is limited regarding potentially differing PCOS phenotypes among women around the world.ObjectiveTo use Flo app technology to understand the multifaceted characteristics of PCOS across several countries and identify contributing risk factors to the development of this condition.Study designFlo is a widely used female health and wellbeing app with period tracking functionality that provides a globally representative and medically unbiased perspective on PCOS symptomatology. A chatbot dialog on PCOS was subsequently administered on the Flo application (app) to users from 142 countries (with at least 100 respondents) who have the app running in English during September–October 2019.ResultsFor analyses, we selected the five countries with the greatest number of respondents: US (n = 243,238), UK (n = 68,325), India (n = 40,092), Philippines (n = 35,131), and Australia (n = 29,926). Bloating was the most frequently reported symptom among PCOS-positive women and appeared to be the main predictor of PCOS in our model (odds ratio 3·76 [95% CI 3·60–3·94]; p < 0·0001). Additional top predictors of PCOS are high blood cholesterol and glucose levels. As BMI increased, the percentage of women who reported a physician-confirmed PCOS diagnosis also increased. However, women in India did not follow this trend.ConclusionOur findings are based on the largest known PCOS dataset and indicate that symptoms are more complex than previously understood. The most frequently reported symptoms (bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness) are broader than those included in the Rotterdam criteria. Future work should reevaluate and refine the criteria utilized in PCOS diagnosis.
Highlights
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 5–20% of women worldwide
The most frequently reported symptoms are broader than those included in the Rotterdam criteria
What are the key findings? Among the five countries with the highest number of Flo app users, the highest ratio of PCOS positive users occurred in the Philippines, followed by India, UK, US, and Australia
Summary
Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 5–20% of women worldwide. It is characterized by excess androgen production, ovulatory dysfunction, and menstrual irregularities. PCOS presents a significant public health concern and requires comprehensive and consistent diagnostic criteria to accurately diagnose and care for the affected population [2]. In 2003, the Rotterdam consensus refined criteria widely used today, which requires the presence of at least two of the following: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries on ultrasound [4, 5]. Polycystic ovary syndrome (PCOS) is a complex and multi-faceted endocrine disorder that affects 5–20% of women. Literature is limited regarding potentially differing PCOS phenotypes among women around the world
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