Polycystic ovary syndrome (PCOS) affects 5–18% of women, and is a reproductive, metabolic, and psychological condition with impacts across the lifespan. The cause is complex, and includes genetic and epigenetic susceptibility, hypothalamic and ovarian dysfunction, excess androgen exposure, insulin resistance, and adiposity-related mechanisms. Diagnosis is recommended based on the 2003 Rotterdam criteria and confirmed with two of three criteria: hyperandrogenism (clinical or biochemical), irregular cycles, and polycystic ovary morphology. In adolescents, both the criteria of hyperandrogenism and irregular cycles are needed, and ovarian morphology is not included due to poor specificity. The diagnostic criteria generates four phenotypes, and clinical features are heterogeneous, with manifestations typically arising in childhood and then evolving across adolescent and adult life. Treatment involves a combination of lifestyle alterations and medical management. Lifestyle optimisation includes a healthy balanced diet and regular exercise to prevent excess weight gain, limit PCOS complications and target weight reduction when needed. Medical management options include metformin to improve insulin resistance and metabolic features, combined oral contraceptive pill for menstrual cycle regulation and hyperandrogenism, and if needed, anti-androgens for refractory hyperandrogenism. In this Review, we provide an update on the pathophysiology, diagnosis, and clinical features of PCOS, and discuss the needs and priorities of those with PCOS, including lifestyle, and medical and infertility treatment. Further we discuss the status of international evidence-based guidelines (EBG) and translation, to support patient self management, healthcare provision, and to set research priorities.

多囊卵巢综合征 (PCOS) 影响 5-18% 的女性，是一种生殖、代谢和心理疾病，会影响整个生命周期。原因很复杂，包括遗传和表观遗传易感性、下丘脑和卵巢功能障碍、过多的雄激素暴露、胰岛素抵抗和肥胖相关机制。建议根据 2003 年鹿特丹标准进行诊断，并通过以下三个标准中的两个进行确认：高雄激素血症（临床或生化）、不规则周期和多囊卵巢形态。在青少年中，高雄激素血症和不规则周期的标准都需要，由于特异性差，卵巢形态不包括在内。诊断标准产生四种表型，临床特征异质，表现通常出现在童年时期，然后在青少年和成年生活中演变。治疗包括生活方式改变和医疗管理的结合。生活方式优化包括健康均衡的饮食和定期锻炼，以防止体重过度增加、限制 PCOS 并发症并在需要时实现减重目标。医疗管理选择包括改善胰岛素抵抗和代谢特征的二甲双胍，用于调节月经周期和高雄激素血症的联合口服避孕药，如果需要，还可以使用抗雄激素药物治疗难治性高雄激素血症。在这篇综述中，我们更新了 PCOS 的病理生理学、诊断和临床特征，并讨论了 PCOS 患者的需求和优先事项，包括生活方式、药物治疗和不孕症治疗。