Polycystic Ovary Syndrome (PCOS) is a serious genetic, hormone, metabolic and reproductive disorder that affects women all over the world. It can cause complications for the whole lifetime of a person, it can lead to obesity, depression, anxiety, infertility and other psychological disorders; including problems with hair loss and skin issues, endometrial cancer, cardiovascular disease, type 2 diabetes, stroke, liver failure and other serious illnesses.

Some number related to PCOS:

• 10-15% of women in the USA have PCOS.
• 50% of women with that condition become diabetic or prediabetic before they turn 40.
• There is a twice bigger chance for women with Polycystic ovary syndrome to be hospitalized.
• 50% of Americans with PCOS are undiagnosed or misdiagnosed.
• Annual economic burden is $8 billion.
• Pregnant women with PCOS have higher risk of getting preeclampsia, gestational diabetes, hypertension, cesarean delivery, preterm delivery, miscarriage and even fetal and infant death.
• Women who have PCOS are 2-6x more likely to have endometrial cancer.
• 200k+ cases of stroke because of having PCOS.

Common factors that can lead to PCOS:

• Age;
• High blood pressure;
• Diabetes;
• Smoking;
• Total cholesterol;
• Triglyceride;
• Low-High-density lipoprotein – cholesterol.

Where does Polycystic Ovary Syndrome actually start?

The research from 2017 states that polycystic ovary syndrome could start not only in the ovaries, but in the brain too. This dreadful disease affects 1 in 10 women all over the world.

PCOS can be really frustrating, especially that it can take a long time, sometimes even a couple years, to diagnose it. Again, there are a variety of reasons: ovarian cysts, obesity, difficulty ovulating, issues with skin and hair, anxiety, depression, heavy periods and all other reasons mentioned above.

There are a lot of doctors who don’t want to find out the initial cause of the PCOS, so they just prescribe their patient to take pills or take hormonal medication to manage some symptoms. Polycystic ovary syndrome can be the cause of anovulatory infertility (when women are not ovulating), in a total of more than 75% cases. Still it is really hard to understand why PCOS starts and how to treat it.

University of New South Wales in Australia carried out research with mice. It was proved that mice not having receptors for androgens, male sex steroid hormone, like testosterone, have PCOS that started in the brain. However, if you remove the androgen receptors from the ovaries, the PCOS can arise back again. This research is quite compelling because humans and mice have many similarities in their reproductive systems.

“For the first time we have a new direction of where we should be looking to try and develop treatments that will treat the cause of PCOS, the androgen excess in the ovary but also in the brain,” said lead researcher Kirsty Walters in a press release.

One of the most consistent factors of PCOS is an increase of the levels of androgen, hyperandrogenism. The gathered data of the research with mice gave two vital points: the effect of androgens on the human brain is really serious to the development of the polycystic ovary syndrome; and that researchers proved their point about the levels of androgen being the reason for the disease.

This study gave a momentous impact on finding the cause of PCOS, but there is still a lot of work and research to do , focusing on the prevention measures and effective treatment.

Another group of researchers of the French National Institute of Health and Medical Research have found out that PCOS may be caused by hormonal imbalance before birth, which can be triggered by an excess exposure in the womb to an anti-Mullerian hormone. It was also proven that pregnant women have 30% higher levels of that hormone because of the polycystic ovary syndrome. They also used mice, pregnant mice, to detect the development of the PCOS. Researchers injected the mice with AMH, after that the offsprings became bigger, they had a lot of symptoms of the disease. Also the symptoms like delays in falling pregnant and unstable ovulating were detected.

The AMH must have stimulated brain cells that raised the levels of testosterone. Researchers treated the mice using an IVF drug, and the symptoms of PCOS were gone.

Ways to detect PCOS

There doesn’t exist a single test that can detect PCOS, you should to a couple of tests to actually found out if you have this disease, such as:

• Pelvic exam,to look for signs of having high levels of male hormones and check if the ovaries are swollen or enlarged.
• Physical exam: general tests, measure body max index, blood pressure, check your body for extra quantity of hair, skin problems.
• Sonogram, pelvic ultrasound, that is used to search for cysts and examine endometrium.
• Blood tests.

Types of medicines that treat Polycystic Ovary Syndrome:

• Metformin. It lowers blood sugar, insulin and androgen levels. Metformin is used to treat type 2 diabetes, after a few months of usage it can help with ovulation. However, it may not help with hair loss problems or acne. Latest research states that metformin can help with obesity and improve levels of cholesterol.
• Hormonal birth control, It can help with regulation of the menstrual cycle, reduce the risk of having endometrial cancer and improve the state of skin, hair and body.
• Anti-androgen medicine. It can stop the spread of androgen, help with acne and hair loss, but it can lead to serious problems during pregnancy.

Treatment for PCOS is quite individual, it is based on a person’s symptoms and test results. It is better to consult with your physician, go through the whole treatment history and do a few tests to detect different symptoms of PCOS.

Sources:

1. PCOS Challenge Support Network;
2. PNAS;
3. NHS;

Office on Women’s Health https://www.womenshealth.gov/