Magnetic vs stapled technique in jejuno-ileal bipartition: one-year outcomes.

Polycystic ovary syndrome (PCOS)—renamed as polyendocrine metabolic ovarian syndrome (PMOS) by expert consensus in 2026— is an endocrine condition characterized by ovulatory dysfunction and hyperandrogenism. The lifetime risk of developing PCOS in developed nations ranges from 8-13%, with peak age incidence occurring before ages 20-25 years. While diagnostic criteria for PCOS have changed over the years, the 2023 recommendations state that the diagnosis requires ≥2 of the following: 1) ovulatory dysfunction or irregular menstrual cycles, 2) clinical or biochemical hyperandrogenism, and 3) polycystic-appearing ovaries (via pelvic imaging) (). PCOS has wide-ranging health consequences, including metabolic disorders, obesity, and infertility. Risk factors for PCOS include genetics, lifestyle factors, insulin resistance, and hormonal imbalances. Early life adversities have been associated with poor mental and physical health, but their effects on gynecologic disorders are understudied. They are hypothesized to influence PCOS risk via chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in ovarian and menstrual dysfunction via effects on the hypothalamic-pituitary-gonadal (HPG) axis (). Studies of early life adversities and PCOS have been cross-sectional in design. Overall, these studies indicate consistent positive associations between adverse childhood experiences (ACEs) and PCOS, with individuals reporting higher adversity (e.g., ≥4 ACEs vs. none) having approximately two- to three-fold higher odds of PCOS. Across studies, multiple domains of adversity—including abuse (emotional, physical, and sexual), household dysfunction, and stressors such as bullying and community violence—have been associated with increased odds of PCOS, although findings for subtypes of abuse (sexual vs. physical) have been heterogeneous, likely reflecting small sample sizes and differences in exposure assessment. While some studies showed similar magnitudes of association for sexual and physical abuse, other studies showed stronger effects for physical abuse (OR=2.5) than sexual abuse (OR=1.0) or did not assess either physical or sexual abuse. All studies relied on self-reported exposures and all but one study relied on self-reported PCOS. None of these studies evaluated frequency or chronicity of abuse, or effect measure modification by resilience factors, though prospective cohort studies of other gynecologic outcomes (e.g., uterine leiomyomata) have shown buffering of effects by childhood social support and adult coping skills. Among North American pregnancy planners, we examined early life adversities—including subtypes, frequency, timing, and chronicity of abuse—in relation to the prevalence of self-reported physician-diagnosed PCOS. In secondary analyses, we assessed the extent to which associations were buffered by social support in childhood and adulthood.