Association between the persistent organic pollutants and polycystic ovary syndrome: A protocol for a systematic review and meta-analysis

Environmental Exposures and Polycystic Ovary Syndrome: A Review

Polycystic ovary syndrome (PCOS) is the most common heterogeneous endocrine disorder in women of reproductive age, affecting around 5 to 10% of women and up to 21% depending on the applied diagnostic criteria and study population. People with PCOS may experience oligomenorrhea, androgen excess, and polycystic ovary morphology. The etiology of the disease is not completely understood, with genetics, epigenetics, endocrine, metabolic, lifestyle, and environmental factors contributing to its development and severity. Environmental exposures are an important, burgeoning field in menstrual research, as they potentially link to menstrual cycle disruption and the risk of reproductive disorders such as PCOS. This review examines the recent research investigating environmental exposures-air pollution, micro- and nanoplastics, heavy metals, and endocrine-disrupting chemicals-and PCOS in human and animal models, concluding with potential mechanisms, limitations, and considerations for future work. Overall, research on environmental exposures and PCOS is limited and yields heterogeneous results across studies. Specifically, exposures such as air pollutants, micro- and nanoplastics, persistent organic pollutants, and parabens have noticeably limited research. Future research can help fill the gap in understanding how environmental exposures, particularly across gestational, childhood, and reproductive adult life stages, may impact PCOS.

Factors influencing the prevalence of polycystic ovary syndrome (PCOS) in the United Arab Emirates

Statistics indicate that at least 20-25% of women suffer from PCOS in the Gulf region. Despite its prevalence and negative implications on reproductive, metabolic, and physiological heath the exact cause of PCOS is unknown, in part due to the diversity of symptoms manifested by this disorder. In this review, we investigate causes of PCOS globally and draw on these studies, to determine the potential contributing factors for PCOS pathogenesis in the UAE population. The most frequently identified factors promoting PCOS pathogenesis that may be pertinent to this population include physiological factors such as insulin resistance, vitamin D deficiency, genetic factors, obesity, and anti-mullerian hormone (AMH) levels in the body as well as environmental factors such as air pollution, endocrine disrupting chemicals, and pesticide use. This evidence will help inform healthcare workers and government agencies to set up optimal guidelines for control and awareness of PCOS in the UAE.