Background: Polycystic ovarian syndrome (PCOS) affects at least 17-20% of female population. Little information is available about whether PCOS is related to low bone mineral density (BMD). In this meta-analysis, we try to explore and compare PCOS patient and normal female population to determine the relation between PCOS patients and osteoporosis as an outcome.

Methods: Two investigators searched published studies indexed in MEDLINE and EMBASE. This review included published observational studies evaluating the association between PCOS and bone mass, BMD, or osteoporosis. PCOS is diagnosed base on clinical, biochemical, radiological findings per Rotterdam criteria. The primary outcome of this study were differences in the total BMD (g/cm2) or BMD at different anatomical sites including lumbar spine, pelvis, femur and total body as measured by dual-energy X-ray absorptiometry between patients with PCOS and participants without PCOS (controls).

Results: Five cross sectional studies involving 1276 participants were included. Meta-analysis using the random-effects model to examine the difference in outcomes between PCOS and controls are performed. The pooled mean difference of total BMD in patients who have PCOS vs. controls in the five studies was -0.22 (95% confidence interval, -0.66 to 0.23; P = 0.35). The statistical between-study heterogeneity may represent substantial heterogeneity with an I2 of 99% (p<0.01). For femoral neck BMD, the difference was not statistically significant, which was 0.00 (95% confidence interval, -0.03 to 0.02; P = 0.81). For lumbar spine BMD, the difference was also not statistically significant, which was -0.02 (95% confidence interval, 0.02; P = 0.25).

Conclusion: Women with PCOS have seemed to increase a chance of having osteoporosis more than the normal population. The real mechanism of PCOS and osteoporosis and a larger PCOS population need to be clarified and study more in the future.


S. Upala: None. D.A. Ehrmann: None.

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