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Background: PCOS is far more than an ovarian disorder; it is a systemic metabolic crisis affecting 11-13% of women. This review maps its extra-ovarian reach into the liver, heart, muscle, and pancreas. Methods: We analyzed how the "pathophysiological quartet"-insulin resistance, hyperandrogenism, inflammation, and oxidative stress-coordinates systemic damage. Results: PCOS prevalence skyrockets to 28.3% in women with obesity. Key findings include a 51.61% prevalence of MASLD in obese patients and a 2-4 fold increase in cardiovascular and type 2 diabetes risk. These manifestations are rooted in a shared metabolic "soil," creating a vicious cycle of androgen excess and multi-organ dysfunction, including sarcopenia and β-cell exhaustion. Conclusion: Fragmented care is insufficient. The systemic nature of PCOS demands a paradigm shift toward integrated, multidisciplinary management, treating the patient as a metabolic whole.
Li et al. (Fri,) studied this question.