Global Trends in Polycystic Ovary Syndrome Burden, 1990–2021: Insights from the Global Burden of Disease Study

Objective: Utilizing the 2021 Global Burden of Disease (GBD) data, this study assessed the global epidemiological landscape of polycystic ovary syndrome (PCOS), offering an empirical foundation for PCOS-related health service planning. Methods: Data from the GBD 2021 database were extracted to examine the global distribution and trends of PCOS. The metrics included total case counts, prevalence, disability-adjusted life years, age-standardized prevalence rate (ASPR), and estimated annual percentage change (EAPC). Analyses incorporated age–period–cohort modeling and frontier efficiency assessments. Results: Between 1990 and 2021, the global ASPR of PCOS exhibited a marked upward trajectory. Significant regional heterogeneity was observed; Southeast, East, and South Asia registered the steepest ASPR growth, whereas tropical Latin America and high-income Asia Pacific displayed relatively stable trends. At the national level, countries such as Equatorial Guinea, Maldives, and Myanmar recorded ASPR increases exceeding 100%, in contrast to reductions seen in high-income nations including Italy. Age-specific patterns revealed that women aged 20–44 years consistently bore the highest burden. The age–period–cohort analysis indicated heightened risk in more recent birth cohorts from low- and middle-socioeconomic development index (SDI) regions, coupled with persistent health disparities despite some narrowing in socioeconomic gaps, as reflected by a decline in concentration indices from 0.24 to 0.1. The frontier analysis identified high-SDI countries, including the United States and Japan, as performing suboptimally in mitigating the PCOS burden relative to their resource capacity. Conclusion: The global burden of PCOS has intensified over the past three decades, with a disproportionate impact in low- and middle-SDI regions. The syndrome predominantly affects women of reproductive age, especially those between 20 and 39 years of age. Although socioeconomic inequalities have lessened to some extent, disparities remain significant, and resource-rich nations continue to underperform in addressing the disease burden. Comprehensive strategies emphasizing timely diagnosis, equitable health care access, and lifestyle interventions are imperative to address this escalating global health concern.