Polycystic ovary syndrome in women with bipolar affective disorder or epilepsy exposed to valproic acid: a nationwide 16-year cohort study

Valproate exposure was associated with an increased risk of PCOS. The risk was especially pronounced during current and cumulative exposure, whereas overall cumulative exposure suggested increased risk at higher thresholds. These findings suggest that PCOS risk may be driven by acute pharmacological effects, although long-term cumulative use may also contribute. The results reinforce recommendations to avoid valproate in women of reproductive age when possible.