title: Diagnosis and management of polycystic ovary syndrome in the UK (2004-2014): a retrospective cohort study.
abstract: To estimate the incidence and prevalence of polycystic ovary syndrome (PCOS) in UK primary care and investigate prescribing patterns before and after a PCOS diagnosis.
  
  
  
  Retrospective cohort study.
  
  
  
  UK primary care (2004-2014).
  
  
  
  Women aged 15-45 years.
  
  
  
  The incidence and prevalence of diagnosed PCOS and probable PCOS (ie, those without a confirmed diagnosis but with at least 2 PCOS features recorded within 3 years). Among women with diagnosed or probable PCOS, the prevalence of prescribing of drugs typically used to treat PCOS was calculated prior to and in the 24 months after the diagnosis of PCOS.
  
  
  
  We identified 7233 women with PCOS diagnoses and 7057 women with records suggestive of probable PCOS, corresponding to incidence rates of 0.93 and 0.91 per 1000 person-years at risk (PYAR) and an overall rate of 1.84 per 1000 PYAR. Women aged 20-24 years and women living in deprived areas had the highest incidence of PCOS. The prevalence of PCOS in 2014 was ∼2%. The proportion of women with a prescription in the 24 months after their PCOS index date varied by drug type: 10.2% metformin, 15.2% combined oral contraceptives, 18.8% acne-related treatments, 1.93% clomiphene, 1.0% spironolactone, 0.28% cyproterone and 3.11% eflornithine. Acne-related treatments were more commonly used to treat probable (28.3%) than diagnosed (12.3%) cases, while metformin was prescribed much more commonly in diagnosed cases.
  
  
  
  In conclusion, compared to rates estimated in community samples, the incidence and prevalence of women presenting in primary care with PCOS diagnoses and features are low, indicating that PCOS is an under-recognised condition. Although considerable variation is observed in treatments prescribed to women with PCOS, the treatments initiated following a confirmed diagnosis generally reflect the long-term prognostic concerns raised in PCOS consensuses.
authors.affiliation: Department of Statistical Science, University College London, London, UK.
authors.forename: Tao
authors.initials: T
authors.lastname: Ding
authors.affiliation: Department of Statistical Science, University College London, London, UK.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baio
authors.affiliation: Institute for Women's Health, University College London Medical School, London, UK.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Hardiman
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Cormac
authors.initials: C
authors.lastname: Sammon
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy / Q000209:etiology; D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011203:Poverty; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011320:Primary Health Care; D011379:Prognosis; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D007004:Hypoglycemic Agents; D008687:Metformin
keywords: EPIDEMIOLOGY; Polycystic Ovary Syndrome; prescription