BACKGROUNDPolycystic ovary syndrome (PCOS) is a common condition affecting ∼8% of women. The objective of the present study was to quantify separately the risk of endometrial cancer, ovarian cancer and breast cancer in women with PCOS compared with non-PCOS controls, and quantify separately the risk to women of all ages as well as the risk to premenopausal women.METHODSWe conducted a systematic review and meta-analysis of observational studies. Studies were eligible for inclusion if they compared women with PCOS to non-PCOS groups for fatal or non-fatal gynaecological cancers. Studies listed in MEDLINE and EMBASE published up to 7 October 2013 in any language were identified, and relevant papers were also searched by hand. Relevant data (for example, study design, source of control data, diagnostic criteria) were extracted and tabulated.RESULTSFrom 698 references, 11 studies (5 of endometrial cancer and 3 each of ovarian and breast cancer) met the inclusion criteria for the meta-analysis (919 women with PCOS and 72054 non-PCOS controls). Using the Mantel–Haenszel method, with fixed or random effects model as appropriate, women with PCOS were at a significantly increased risk of endometrial cancer (odds ratio (OR), 2.79; 95% confidence interval (CI), 1.31–5.95, P < 0.008), but the risk of ovarian and breast cancers was not significantly increased (OR, 1.41; 95% CI, 0.93–2.15, P < 0.11 and OR, 0.95; 95% CI, 0.64–1.39, P < 0.78, respectively). However when studies which included women aged over 54 years were excluded from the analysis, the risk for women with PCOS increased further for endometrial cancer (OR, 4.05; 95% CI, 2.42–6.76, P < 0.00001), became significantly increased for ovarian cancer (OR, 2.52; 95% CI, 1.08–5.89, P < 0.03), but remained non-significant for breast cancer (OR, 0.78; 95% CI, 0.46–1.32, P < 0.35).CONCLUSIONSThis is the first meta-analysis to examine gynaecological cancers in women with PCOS younger than 54 years of age compared with controls of similar age. Current data suggest that women of all ages with PCOS are at an increased risk of endometrial cancer but the risk of ovarian and breast cancer was not significantly increased overall. These results highlight the potential risk of gynaecological cancer morbidities associated with PCOS. However, the available evidence is far from robust and variation in diagnostic criteria for PCOS, associated risk factors (particularly obesity), and selection bias in the studies may have resulted in an exaggeration of the increased risk. Furthermore, women who have PCOS should also be made aware that any increased risk for endometrial cancer must be judged in the context of its relatively low incidence in the general population. A large well-controlled prospective study is required in order to gain a more accurate estimate of the risk of gynaecological cancers in women with PCOS.PROSPERO CRD REGISTRATION NUMBERCRD42012003500.

Women with PCOS on average tend to experience mildly elevated anxiety and depression, significantly more than women without PCOS. Women with PCOS with lower BMI tended to have slightly lower anxiety and depression scores, suggesting that having a lower BMI reduces anxiety and depression. Future studies might consider (i) controlling for BMI, (ii) stratifying by medication use in order to control for any anti-androgenic effects of medication and (iii) excluding women with polycystic ovaries from control groups.

Objective. There is some evidence that men and women deal with stress in different ways; for example, a meta-analysis found that women prefer to focus on emotions as a coping strategy more than men do. However, sex differences in preferences for therapy is a subject little explored. Design.A cross-sectional online survey.Method. Participants (115 men and 232 women) were recruited via relevant websites and social media. The survey described therapies and asked participants how much they liked each. Their coping strategies and help-seeking behaviour were assessed too.Results. Survey data were analysed using multiple linear regression. After familywise adjustment of the alpha for multiple testing to p < .0125, and controlling for other relevant variables, men liked support groups more than women did (b = À.163, p < .010), used sex or pornography to cope with stress more than women did (Exp [B] = .280, p < .0002), and thought that there is a lack of male-friendly options more than women did (Exp[B] = .264, p < .002). The majority of participants expressed no preference for the sex of their therapist, but of those who did, men were only slightly more likely to prefer a female therapist whereas women were much more likely to prefer females (p < .0004). Even after familywise adjustment, there were still more significant findings than would be expected by chance (p < .001, two-tailed).Conclusions. Although there are many similarities in the preferences of men and women regarding therapy, our findings support the hypothesis that men and women show statistically significant differences of relevance to clinical psychologists. Practitioner pointsMen are less inclined than women to seek help for psychological issues This study demonstrates that men and women show significant differences in some aspects of therapy, coping behaviour, and help-seeking It is possible that men would be more inclined to seek help if therapies catered more for men's preferences Practitioners can learn to improve the success of their practice by taking the gender of clients into account

The aetiology of polycystic ovary syndrome (PCOS) is poorly understood, but an intrauterine hyperandrogenic environment has been implicated. This study was designed to assess whether the female offspring of mothers with PCOS are exposed to raised levels of testosterone (T) in utero. In this case-control study, three groups of pregnant women were recruited from the labour ward: PCOS women with a female baby (n = 10, PCOS girls); control women with a female baby (n = 20, control girls) and control women with a male baby (n = 10, control boys). Maternal and umbilical vein (UV) blood was assayed for T levels. UV T in PCOS girls was significantly raised, compared with control girls (p < 0.012). The difference in UV T between PCOS girls and control boys was not significant (p < 0.254). This is the first demonstration of a hyperandrogenic in utero environment in PCOS pregnancies; UV T in female infants is raised to male levels.

From an early age, most children choose to play with toys typed to their own gender. In order to identify variables that predict toy preference, we conducted a meta‐analysis of observational studies of the free selection of toys by boys and girls aged between 1 and 8 years. From an initial pool of 1788 papers, 16 studies (787 boys and 813 girls) met our inclusion criteria. We found that boys played with male‐typed toys more than girls did (Cohen's d = 1.03, p < .0001) and girls played with female‐typed toys more than boys did (Cohen's d = −0.91, p < .0001). Meta‐regression showed no significant effect of presence of an adult, study context, geographical location of the study, publication date, child's age, or the inclusion of gender‐neutral toys. However, further analysis of data for boys and girls separately revealed that older boys played more with male‐typed toys relative to female‐typed toys than did younger boys (β = .68, p < .0001). Additionally, an effect of the length of time since study publication was found: girls played more with female‐typed toys in earlier studies than in later studies (β = .70, p < .0001), whereas boys played more with male‐typed toys (β = .46, p < .05) in earlier studies than in more recent studies. Boys also played with male‐typed toys less when observed in the home than in a laboratory (β = −.46, p < .05). Findings are discussed in terms of possible contributions of environmental influences and age‐related changes in boys' and girls' toy preferences. Highlights Gender differences in toy choice exist and appear to be the product of both innate and social forces. Despite methodological variation in the choice and number of toys offered, context of testing, and age of child, the consistency in finding sex differences in children's preferences for toys typed to their own gender indicates the strength of this phenomenon and the likelihood that has a biological origin. The time playing with male‐typed toys increased as boys got older, but the same pattern was not found in girls; this indicates that stereotypical social effects may persist longer for boys or that there is a stronger biological predisposition for certain play styles in boys.

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link Preferences for gender-typed toys in boys and girls aged nine months to 32 months old ABSTRACTMany studies have found that a majority of boys and girls prefer to play with toys which are typed to their own gender, but there is still uncertainty about the age at which such sex differences first appear, and under what conditions. Applying a standardized research protocol and using a selection of gender-typed toys, we observed the toy preferences of boys and girls engaged in independent play in UK nurseries, without the presence of a parent. The 101 boys and girls fell into three age groups: nine months to 17 months, when infants can first demonstrate toy preferences in independent play (N = 40), 18 to 23 months, when critical advances in gender knowledge occur (N = 29) and 24 to 32 months, when knowledge becomes further established (N = 32). Stereotypical toy preferences were found for boys and girls in each of the age groups, demonstrating that sex differences in toy preference appear early in development . Both boys and girls showed a trend for an increasing preference with age for toys stereotyped for boys. Theoretical implications of the findings are discussed with regard to biological predispositions, cognitive development and environmental influences on toy preference.

The present study describes a novel finding regarding changes in clot mechanics in late pregnancy/puerperium and supports the concept of using thromboelastography as part of the routine assessments at delivery.

Women with polycystic ovary syndrome (PCOS), one of the commonest endocrine conditions in the human, are more likely than other women to have increased blood pressure, endothelial dysfunction, reduced arterial compliance, central obesity, dyslipidaemia, low grade chronic inflammation, and increased endothelin-1 and homocysteine [1]. A recent meta-analysis found an increased incidence of cardiovascular events in women with PCOS, but did not distinguish between coronary heart disease and stroke and did not consider fatal and non-fatal events separately [2]. The present metaanalysis aimed to quantify the risk of non-fatal stroke and coronary heart disease as separate disease events in women with PCOS compared to healthy women.The Mantel-Haenszel method was used, with a random effects model in most cases, to generate an odds ratio (OR) for all included studies combined. Results were considered statistically significant where the probability value was below the 0.05 threshold. Review Manager statistical software, version 5.1, was used to analyse data. Heterogeneity was assessed using I 2 and chi square statistics.Nine studies met the inclusion criteria (see list of included studies here [www.ijc.com/references). Women with PCOS were at increased risk of non-fatal stroke and non-fatal CHD but the odds ratios did not reach statistical significance (OR, 1.61; 95% CI, 0.82-3.15; P = 0.17 and OR, 1.63; 95% CI, 0.96-2.78; P = 0.07, respectively). In the five studies where the average age was more than 45 years old, the risk in PCOS was significantly increased for non-fatal stroke (OR, 1.94; 95% confidence interval, 1.19-3.17) and non-significantly increased in the six studies of CHD (OR, 1.70; 95% confidence interval, 0.92-3.11) (Fig. 1).For the three studies where the BMI was similar and the mean age was over 45 in the groups the risk was non-significantly increased for women with PCOS for stroke (OR, 1.67; 95% confidence interval, 0.70-4.02) and for the three studies of CHD (OR, 2.04; 95% confidence interval, 0.60-6.97).The Newcastle-Ottawa scale suggests that the methodological quality of the included studies was moderate. Funnel plots found that although publication bias cannot be ruled out, the asymmetry observed may be due to the relatively young age of the patients in one study.Women with PCOS appear to be at increased risk of non-fatal stroke and possibly CHD. Although this study was not designed to investigate mechanism, the higher blood pressure and atherogenic lipid profile in women with PCOS may be contributory. In any case, clinicians and policymakers might focus on screening women with PCOS as soon as it is diagnosed, and focus on applying preventative measures, such as lifestyle interventions, appropriate to reducing the risk of stroke.Whilst the results of the present meta-analysis did not provide evidence of increased risk of CVD in PCOS entirely independent of BMI, evidence of cardiovascular risk in lean women with PCOS [3] supports the hypothesis of the potential for an independent role of PCOS in CVD, pe...