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The aetiology of the syndrome is complex, with genetic susceptibility, androgen exposure in early life and adiposity related dysfunction leading to perturbance in hypothalamic\u2013ovarian function. PCOS clinical features are heterogeneous, with manifestations arising even in early adolescence, developing into multisystem reproductive, metabolic and psychological manifestations in adulthood. In this review, we will discuss challenges in the diagnosis of PCOS and understanding of the natural history of PCOS.<\/jats:p>","DOI":"10.1111\/cen.14757","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T08:25:05Z","timestamp":1653035105000},"page":"165-173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Challenges in diagnosis and understanding of natural history of polycystic ovary syndrome"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6307-2568","authenticated-orcid":false,"given":"Anju E.","family":"Joham","sequence":"first","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Diabetes and Vascular Medicine Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-7300","authenticated-orcid":false,"given":"Terhi","family":"Piltonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital University of Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla E.","family":"Lujan","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences Cornell University Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4188-7755","authenticated-orcid":false,"given":"Sylvia","family":"Kiconco","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6228-2654","authenticated-orcid":false,"given":"Chau Thien","family":"Tay","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Diabetes and Vascular Medicine Monash Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew218"},{"key":"e_1_2_10_3_1","first-page":"533","article-title":"The prevalence of polycystic ovary syndrome in adolescents: a systematic review and meta\u2010analysis","volume":"17","author":"Naz MSG","year":"2019","journal-title":"Int J Reprod Biomed"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh098"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1738"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2014.5000"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex044"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.03.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2020.104678"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz256"},{"key":"e_1_2_10_11_1","unstructured":"International evidence\u2010based guideline for the assessment and management of polycystic ovary syndrome. 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