Polycystic Ovary Syndrome (PCOS) from our Healthcare Partner, Innovation Compounding

Content Feature from Innovation Compounding

PCOS stands for Polycystic Ovary Syndrome, but it is not actually exclusively defined by ovarian cysts. PCOS is the most frequent endocrine condition in premenopausal women is (PCOS). The global prevalence of this illness ranges from 6% to 20% depending on the diagnostic criteria used, with a higher prevalence among overweight or obese women and among ethnic groups.

PCOS is a complicated endocrine condition characterized by clinical or biochemical hyperandrogenism, ovarian dysfunction (menstrual irregularities), and polycystic ovarian morphology, among other issues. There is currently a plethora of PCOS diagnosis criteria that include various combinations of its clinical features. The Rotterdam criteria, which is mostly employed for clinical diagnosis, require at least two of the three clinical characteristics listed above.

PCOS is regarded as a major cause of anovulatory infertility and is therefore clinically linked to subfertility or infertility.[6]. However, the pathology’s negative impact is not limited to reproductive function. PCOS is also connected to numerous metabolic problems such as obesity and insulin resistance (IR).[7] A considerable number of women with PCOS are overweight, and they often have IR with hyperinsulinemia.[8,9] IR is the most prevalent metabolic perturbation in women with PCOS, affecting 65–70% of all patients. Notably, IR and hyperinsulinemia are metabolic features shared by most slim women with PCOS as well. Hyperinsulinemia also contributes to the development of various phenotypic aspects of PCOS. In conjunction with BETA cell dysfunction, it increases the likelihood of developing other metabolic problems such as type 2 diabetes (T2D), hypertension dyslipidemia, and cardiovascular disease. The frequency of these metabolic comorbidities is high in overweight women with PCOS, mostly due to hormonal imbalances such as elevated luteinizing hormone (LH) and normal or suppressed follicle stimulating hormone (FSH) resulting in an altered LH/FSH ratio.

The clinical features of hyperandrogenism are also related to hyperinsulinemia and insulin resistance.

While many elements of PCOS pathogenesis remain unknown, it is believed that hyperandrogenism contributes significantly to the development of many of the reproductive and metabolic abnormalities associated with PCOS. Excess androgen has a detrimental effect on metabolic balance in women with PCOS, affecting a variety of metabolic tissues, including adipose tissue, liver, muscle, pancreas, and the brain. Androgen synthesis in ovarian theca cells is stimulated by insulin. Hyperinsulinemia stimulates cytochrome p450 enzymes in the ovary directly; or indirectly through action of LH or IGF-1, causing hyperandrogenism.

Signs of PCOS

• Dermatological issues: Increased androgen levels are sometimes linked to dermatological issues. These include hirsutism (coarse, black hair on the face, belly, chest, and back), acne, and balding/alopecia. Teenage skin issues are frequently attributable to puberty, not PCOS.

• Menstrual disorders: Menstrual abnormalities can range in severity from the complete absence of menstruation (amenorrhea) to menstruation that is delayed by 35 days or more (oligomenorrhea) to profuse bleeding (menorrhagia). Women who experience irregular menstrual cycles have a 91% risk of developing PCOS. In addition, PCOS patients are 15 times more likely to report infertility than non-PCOS patients.

• Polycystic ovaries: In a single transvaginal ultrasound image, excessive follicles, defined as 25 or more follicles measuring 2 mm to 10 mm, may be seen in PCOS. Additionally, increased ovarian volume, defined as an ovary larger than 10 mL, is also an attribute. Women with PCOS are at risk for developing type 2 diabetes and cardiovascular disease. They are also at a threefold greater risk of developing uterine cancer.[15] In addition, women with PCOS are at higher risk for mental health disorders—such as anxiety and depression. Because of the severe effects of PCOS on many aspects of health, collaborative research efforts will be essential for advancing diagnosis and treatments and reducing the suffering of women with this disorder.

Risk Factors for Developing PCOS

• Genetics: A recent study documented that pregnant woman with PCOS exhibit increased circulating AMH levels compared with control women. Thus, girls born from mothers with PCOS might be at a greater risk of developing this endocrine disorder not only due to the abnormal exposure to androgens during gestation, but also due to the intrauterine AMH excess. Low birth weight due to intrauterine growth restriction is also thought to be a contributing factor for the development of PCOS. Along the same lines, it has been shown that the prevalence of symptoms of PCOS is higher in young adult women born small for gestational age compared to women born with adequate body weight at birth. Such women exhibit altered insulin sensitivity, increased androgenic activity, and irregular menses. These findings suggest that changes in the intrauterine nutritional environment may also be considered a significant factor for the development of PCOS.

• Diet: Diet has also been found to be a contributing factor for PCOS. Dietary fats and proteins can form advanced glycation end products (AGEs) when exposed to sugar in the bloodstream.[20] AGEs are known to contribute to increased bodily stress and inflammation, which have been linked to diabetes and cardiovascular disease. Since PCOS patients already have an increased likelihood for metabolic syndrome, cardiovascular issues, and diabetes it is best to limit exposure to AGEs in these individuals. Animal-derived foods that are high in fat and protein are generally AGE-rich and prone to more AGE formation during cooking.

• Lifestyle: Obesity is a common exacerbating factor for PCOS. Therefore, maintaining a healthy weight is strongly advised. Exercise can alleviate many PCOS symptoms, including depression, inflammation, and excess weight gain. Women with PCOS should be advised to restrict inflammatory foods, such as milk products, gluten foods, and highly glycemic foods such as potatoes, white bread or sucrose desserts.

• Environmental Exposure Risks: According to research, the greatest risk from endocrine disrupting chemicals occurs during prenatal and early postnatal development, when organ systems are developing. Many of the things we use daily include endocrine disruptive chemicals, including some plastic bottles and containers, liners for metal food cans, detergents, flame retardants, food, toys, cosmetics, and pesticides. Reproductive health may benefit from limiting personal exposure to endocrine disrupting substances.

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