Polycystic ovary syndrome research in sub-Saharan Africa: a systematic review on current status and future directions

Objectives Polycystic ovary syndrome (PCOS) is one of the most prevalent disorders affecting women. The status of PCOS research in sub-Saharan Africa is unknown, where non-communicable diseases are prevalent but often underrecognized. To assess current knowledge about PCOS in sub-Saharan Africa and identify gaps in the literature.Methods A systematic search was conducted across PubMed, Embase, Cochrane, and African Journals Online through 9 August 2026 to identify original studies on PCOS in sub-Saharan Africa. Original research studies involving sub-Saharan African populations, without age-related constraints, were eligible. We excluded non-original studies and studies that did not focus on PCOS. Three independent reviewers (S.H., M.A., and C.C.M.) performed the searches.Results Of 1973 retrieved records, 40 studies met the inclusion criteria, predominantly from Nigeria, with additional contributions from South Africa, Cameroon, the Democratic Republic of Congo, Tanzania, Benin, Kenya, and Ethiopia. Most studies were observational and primarily focused on PCOS in the context of infertility. No population-based prevalence studies were identified; however, 13 studies reported PCOS prevalence, mostly in clinically selected populations.Conclusions PCOS remains understudied in sub-Saharan Africa, with substantial gaps in population-based epidemiology, diagnostic practices, phenotype distribution, management, and metabolic outcomes. Addressing these gaps through larger, well-designed studies is critical to accurately assess the disease burden, inform clinical guidelines, and optimize management strategies. Additionally, overcoming barriers such as cultural attitudes, cost, and limited accessibility to diagnostic tools and treatment options remains essential to improving PCOS care and research across the region.PROSPERO registration ID CRD420250649730 – 13 March 2025.