Polycystic Ovary Syndrome (PCOS) is known as a highly prevalent disorder, characterized as the single most common endocrine-metabolic disorder in reproductive-aged women. If this is the case, why is it commonly underdiagnosed and misunderstood? PCOS is a disorder affecting the endocrine and reproductive systems. More specifically, it is a hormone imbalance in the ovaries, creating excess hormones. When this is the case, the ovaries produce incredibly high levels of androgens, commonly known as the male sex hormone. This results in a hormone imbalance. These high levels of androgens restrain the ovaries from releasing eggs and lead to irregular menstrual cycles, acne, obesity, and excessive hair growth (facial/body) in women.
Most patients with PCOS experience oligo-anovulation, characterized by menstrual cycles longer than 35 days, which is linked to ovulatory dysfunction. It is the first reason for female infertility and often includes other etiologies.
Alongside these symptoms, insulin levels increase due to the release of androgens. The majority of patients presented with PCOS have demonstrated chronic insulin resistance. This insulin resistance makes patients with PCOS more likely to have Type 2 diabetes mellitus. In addition to Type 2 diabetes mellitus, metabolic syndrome increases, leading to an increased risk for cardiovascular disease.
Overall, PCOS demonstrates a reduced quality of life, showing an increased risk for anxiety, depression, and other mood disorders. PCOS disorder commonly remains underdiagnosed, and within the clinician community, it is needed to be better understood, educated, and knowledgeable. Future and current clinicians should be able to understand the pathophysiology, diagnosis, and treatment within the female reproductive age group.
Azziz R. (2018). Polycystic Ovary Syndrome. Obstetrics and gynecology, 132(2), 321–336. https://doi-org.dml.regis.edu/10.1097/AOG.0000000000002698
Thank you for sharing this! I wasn't aware that individuals with PCOS also typically suffer from Type 2 Diabetes. I'm curious to understand why its associated with Type 2 as opposed to Type 1. Could this be due to the syndrome's onset at puberty?
ReplyDeleteAs I was quickly researching this question, I stumbled upon an NIH review of what causes PCOS. Researches have apparently found genetic variants in both males and females, with the male genetic variants contributing to cardiac and metabolic symptoms similar those experienced by females with PCOS. I'm now curious to know how exactly these symptoms are presenting, and how they may differ between biological sexes. I'll link the article below for your perusing.
Link: https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/causes
This information is very important and helpful to bring to light. I remember several of my friends suffering from PCOS and not knowing what it was. They struggled with an uncontrollable hormone balance and were just taught to brush it off. It was sad to discover that they had to dig for an answers rather than their physician taking their symptoms seriously. 10 years back I had no idea what it was nor had I ever heard of it. Now as a new generation of educated individuals we try to bring these things out so others don’t suffer the same way. More female reproductive studies are needed to understand the uniques of the female body.
ReplyDeletePCOS indeed presents a complex relationship between endocrine and metabolic dysfunctions. The excess production of androgens is a significant factor in this syndrome, as it contributes to insulin resistance. An article that I came across mentions that this insulin resistance seems to serve as both a symptom and a contributing factor to PCOS, as it further complicates hormonal regulation and can drive weight gain, creating a cycle that exacerbates symptoms (Moghetti & Tosi, 2021). Understanding the physiology behind these mechanisms could be vital in designing interventions that address both androgen levels and insulin sensitivity. However, the high prevalence of metabolic syndrome and increased risk of cardiovascular disease in PCOS patients emphasize the importance of a holistic, interdisciplinary approach.
ReplyDeleteI wonder...what are some of the physiological markers that are often missed or misinterpreted in PCOS diagnosis, and how might future clinical approaches improve early detection?
Reference article:
Moghetti, P., Tosi, F. Insulin resistance and PCOS: chicken or egg?. J Endocrinol Invest 44, 233–244 (2021). https://doi.org/10.1007/s40618-020-01351-0
I am glad you have taken time to bring light to PCOS and the individuals that suffer from this condition. I have read that the symptoms of PCOS often exacerbates the effects of PCOS. Meaning current treatments are being used to treat the symptoms and not the root of the problem. Currently the most common medications for individuals with PCOS are metformin, often prescribed for type 2 diabetes, to combat the insulin resistance aspect. As well has ozempic to treat obesity, in hopes of combatting PCOS overall. I am curious to see how future treatment options evolve, as this condition is becoming more prominent.
ReplyDeleteReference:
https://www.mirror.co.uk/news/health/ozempic-pcos-treatment-doctor-weight-32847698
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1366940/full