Racial and ethnic disparities in polycystic ovary syndrome

VanHise, Katherine; Wang, Erica T.; Norris, Keith C.; Azziz, Ricardo; Pisarska, Margareta D.; Chan, Jessica

doi:10.1016/j.fertnstert.2023.01.031

Cited by 22 publications

(12 citation statements)

References 44 publications

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“…The clinical variation in diagnostic definitions may contribute to the high rates of misdiagnosed and underdiagnosed cases and exacerbate the lengthy diagnostic process for PCOS. 6,7 Timely diagnosis of PCOS is important for patients, especially given comorbidities, such as diabetes, that often develop. The limited data available also suggest that the type and severity of comorbidity may vary by race and ethnicity.…”

Section: + Related Articlementioning

confidence: 99%

“…Unlike the diagnosis of fibroids, which relies on visualization of a fibroid, there are multiple diagnostic criteria and syndromic definitions for PCOS, some of which include physical characteristics, such as excess body hair growth, that are defined based on findings in White populations. The clinical variation in diagnostic definitions may contribute to the high rates of misdiagnosed and underdiagnosed cases and exacerbate the lengthy diagnostic process for PCOS . Timely diagnosis of PCOS is important for patients, especially given comorbidities, such as diabetes, that often develop.…”

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confidence: 99%

“…Timely diagnosis of PCOS is important for patients, especially given comorbidities, such as diabetes, that often develop. The limited data available also suggest that the type and severity of comorbidity may vary by race and ethnicity . As with fibroids, barriers to diagnosis and adequate clinical care result in disparities in who receives a PCOS diagnosis, creating potentially large biases in electronic health record–based research.…”

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confidence: 99%

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Fibroid Prevalence—Still So Much to Learn

2023

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The report from Huang et al 1 elsewhere in JAMA Network Open used a community-based cohort with systematic ultrasonographic screening to document the high fibroid prevalence in reproductiveaged participants (20%), the 2-to 3-fold higher prevalence of fibroids in Black or Asian-Chinese individuals compared with White or Hispanic individuals, and the early age of fibroid onset in both Black and Asian-Chinese participants. In the context of fibroid research, estimates of fibroid prevalence in a diverse community sample are limited. Fibroid-focused epidemiologic research is rare, yet the scarcity of data cannot be explained by unique difficulties of studying this condition given that fibroids are not hard to diagnose. Most studies rely on suboptimal study designs, including secondary analysis of studies designed for other outcomes. The study by Huang et al 1 used ultrasonographic imaging for diagnosis, but the data were collected for a different hypothesis, which

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Section: + Related Articlementioning

confidence: 99%

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confidence: 99%

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Fibroid Prevalence—Still So Much to Learn

2023

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“…Menstrual taboos include not participating in daily activities, or women isolating themselves due to the bad omen that are believed to follow menstruating women, therefore, women prefer not to participate in physical activities when menstruating 9. Other researchers have also explained how cultural traditions and customs prevent sportswomen from Indigenous and ethnic communities from participating in some forms of training and recovery (ie, not entering the water) during menstruation, which can confuse white sports scientists and trainers who do not understand why the players are excusing themselves from particular tasks 18…”

Section: Introductionmentioning

confidence: 99%

“…Medical research examining the relationship between ethnicity and menstrual health in sports women is limited 19. Beyond sports, research has indicated higher risk factors for certain menstrual dysfunctions (ie, polycystic ovarian syndrome) among black and Hispanic women 18. A study conducted by Li et al 20 on the different factors that could impact an individual’s menstrual cycle showed evidence that participants who identified as Asian or Hispanic experienced longer menstrual cycles when compared with other ethnicities.…”

Section: Introductionmentioning

confidence: 99%

Moving from ethnic exclusions to cultural safety: how is athlete ethnicity discussed in research on menstrual health in sports? A scoping review

Gibbons,

Pedlar,

Varner Hemi

et al. 2024

Br J Sports Med

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ObjectiveThis study aims to investigate how athlete ethnicity is discussed in the inclusion and exclusion criteria, methodology, findings, and conclusions of research focused on menstrual health in sports science and medicine.DesignA scoping review of sports-based research conducted on athletes related to (1) menstrual health and ethnicity, (2) how researchers include/exclude participants based on ethnicity and (3) how ethnicity is discussed.Data sourcesElectronic search of PubMed and ProQuest.Eligibility criteriaArticles were included if they met the following criteria: (1) published before September 2023, (2) published in peer-reviewed journals, (3) participants were women athletes, (4) published in English and (5) relating to menstrual health. Articles were assessed as good, fair or poor quality using the Inclusion of Participant Ethnicity Quality Assessment Criteria.ResultsFrom the 1089 studies available from the initial database search, 55 studies considered ethnicity. Nine studies met the inclusion criteria and were assessed as either good (22%), fair (44%) or poor (33%) in quality in their consideration of athlete ethnicity. 81% of research articles on menstrual health in sports do not consider athlete ethnicity, and when ethnicity is discussed, it rarely meets the criteria for cultural safety in the research process. Most studies did not factor ethnicity into the analysis and lacked cultural considerations in the research design and interventions.ConclusionMore careful inclusion of ethnicity in sports menstrual health-related research and recognition of social and cultural influences on health and research outcomes for indigenous and other ethnic minority groups is needed. Such research is required to support coaches, medical personnel and support staff in designing culturally safe environments for sportswomen from diverse cultural and ethnic backgrounds.

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