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The journey to conception is a long, difficult road...
Researchers See Link Between PCOS and Metabolic Syndrome
By Miranda Hitti
WebMD Medical News
Reviewed By Brunilda Nazario, MD
on Wednesday, April 06, 2005
April 6, 2005 -- One of the most common causes of female infertility -- polycystic ovary syndrome
(PCOS) -- may raise the risk of heart disease.
PCOS is a hormone imbalance that interferes with women's normal ovulation. Nearly 2 million U.S.
women could be affected, say doctors from the Medical College of Virginia in The Journal of Clinical
Endocrinology & Metabolism. These women have increased rates of metabolic syndrome, they find.
"These findings support the idea that PCOS should be considered a general health disorder with
serious public health implications," they write. They encourage doctors to screen PCOS patients for
metabolic syndrome, a cluster of abnormalities that raises the risk of heart disease and diabetes.
Common Problem
The study of 106 women with PCOS showed that 43% also had metabolic syndrome. Metabolic
syndrome was twice as common in these women as in women of the same age without PCOS, says
the study.
Because PCOS affects up to 10% of the 50 million reproductive-aged women in the United States, if
the prevalence of metabolic syndrome in PCOS is approximately 40%, then nearly 2 million women
may be affected with both PCOS and the metabolic syndrome, write the researchers.
Symptoms of PCOS include:
Infertility
Eight or fewer menstrual periods in one year
High levels of the male sex hormone testosterone
Excess of thick hair growth on the face, chest, back, stomach, thumbs, or toes
Male pattern baldness
Abnormal vaginal bleeding
Increased risk of uterine cancer
Skin problems such as acne, dandruff, oily skin, and dark skin patches
Depression or mood swings
PCOS can start gradually. Many women (but not all) will have numerous small cysts on their ovaries.
Some women have other symptoms but do not have evidence of ovarian cysts.
To diagnose PCOS, doctors look at many possible causes of excess and abnormal production of male
hormones. Medications and lifestyle adjustments, such as weight loss in overweight women, are
usually used to treat the metabolic problems associated with PCOS.
Insulin resistance is the hallmark of PCOS, say the researchers. The body makes insulin to control
blood sugar.
About Metabolic Syndrome
Insulin resistance is also linked to metabolic syndrome, which can affect men or women. Patients
have at least three of the following traits:
Waist size of more than 40 inches in men or 35 inches in women
Triglyceride blood levels of 150 or greater
HDL ("good") cholesterol less than 40 in men or less than 50 in women
Blood pressure of 130/85 or more
Fasting blood sugar of 100 or more
Participants with PCOS and metabolic syndrome had higher testosterone levels than those without
metabolic syndrome.
They also showed signs of the metabolic syndrome more frequently and may have had more severe
insulin resistance.
Age and obesity didn't change the results. Though the women were 20-39 years old, their prevalence
of metabolic syndrome was typical of women almost twice their age.
"The prevalence rate of metabolic syndrome in our women with PCOS was comparable to the 44%
rate reported for women aged 60-69 in the general population," write John Nestler, MD, and
colleagues.
Nestler leads the Medical College of Virginia's division of endocrinology and metabolism. He has
devoted much of his career to studying PCOS.
Study's Limits
The study included a relatively small number of PCOS patients, and the researchers didn't have all the
data they wanted, since the study was retrospective.
Waist measurements -- a component of metabolic syndrome -- weren't known for all the women, so
BMI (body mass index) was used instead. Formal analysis of excess hair patterns in women with
PCOS weren't available, and insulin resistance wasn't directly measured.
Possibly, some women may have misremembered their menstrual irregularities or family medical
histories, say the researchers.
Still, they say the findings are significant since the women weren't handpicked and the rate of
metabolic syndrome was high.
--------------------------------------------------------------------------------
SOURCES: Apridonidze, T. The Journal of Clinical Endocrinology & Metabolism, April 2005; vol 90:
pp 1929-1935. WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS) --
Topic Overview." WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS)
-- Symptoms." News release, The Endocrine Society. WebMD Medical News: "Do You Have
Metabolic Syndrome?" Medical College of Virginia.
By Miranda Hitti
WebMD Medical News
Reviewed By Brunilda Nazario, MD
on Wednesday, April 06, 2005
April 6, 2005 -- One of the most common causes of female infertility -- polycystic ovary syndrome
(PCOS) -- may raise the risk of heart disease.
PCOS is a hormone imbalance that interferes with women's normal ovulation. Nearly 2 million U.S.
women could be affected, say doctors from the Medical College of Virginia in The Journal of Clinical
Endocrinology & Metabolism. These women have increased rates of metabolic syndrome, they find.
"These findings support the idea that PCOS should be considered a general health disorder with
serious public health implications," they write. They encourage doctors to screen PCOS patients for
metabolic syndrome, a cluster of abnormalities that raises the risk of heart disease and diabetes.
Common Problem
The study of 106 women with PCOS showed that 43% also had metabolic syndrome. Metabolic
syndrome was twice as common in these women as in women of the same age without PCOS, says
the study.
Because PCOS affects up to 10% of the 50 million reproductive-aged women in the United States, if
the prevalence of metabolic syndrome in PCOS is approximately 40%, then nearly 2 million women
may be affected with both PCOS and the metabolic syndrome, write the researchers.
Symptoms of PCOS include:
Infertility
Eight or fewer menstrual periods in one year
High levels of the male sex hormone testosterone
Excess of thick hair growth on the face, chest, back, stomach, thumbs, or toes
Male pattern baldness
Abnormal vaginal bleeding
Increased risk of uterine cancer
Skin problems such as acne, dandruff, oily skin, and dark skin patches
Depression or mood swings
PCOS can start gradually. Many women (but not all) will have numerous small cysts on their ovaries.
Some women have other symptoms but do not have evidence of ovarian cysts.
To diagnose PCOS, doctors look at many possible causes of excess and abnormal production of male
hormones. Medications and lifestyle adjustments, such as weight loss in overweight women, are
usually used to treat the metabolic problems associated with PCOS.
Insulin resistance is the hallmark of PCOS, say the researchers. The body makes insulin to control
blood sugar.
About Metabolic Syndrome
Insulin resistance is also linked to metabolic syndrome, which can affect men or women. Patients
have at least three of the following traits:
Waist size of more than 40 inches in men or 35 inches in women
Triglyceride blood levels of 150 or greater
HDL ("good") cholesterol less than 40 in men or less than 50 in women
Blood pressure of 130/85 or more
Fasting blood sugar of 100 or more
Participants with PCOS and metabolic syndrome had higher testosterone levels than those without
metabolic syndrome.
They also showed signs of the metabolic syndrome more frequently and may have had more severe
insulin resistance.
Age and obesity didn't change the results. Though the women were 20-39 years old, their prevalence
of metabolic syndrome was typical of women almost twice their age.
"The prevalence rate of metabolic syndrome in our women with PCOS was comparable to the 44%
rate reported for women aged 60-69 in the general population," write John Nestler, MD, and
colleagues.
Nestler leads the Medical College of Virginia's division of endocrinology and metabolism. He has
devoted much of his career to studying PCOS.
Study's Limits
The study included a relatively small number of PCOS patients, and the researchers didn't have all the
data they wanted, since the study was retrospective.
Waist measurements -- a component of metabolic syndrome -- weren't known for all the women, so
BMI (body mass index) was used instead. Formal analysis of excess hair patterns in women with
PCOS weren't available, and insulin resistance wasn't directly measured.
Possibly, some women may have misremembered their menstrual irregularities or family medical
histories, say the researchers.
Still, they say the findings are significant since the women weren't handpicked and the rate of
metabolic syndrome was high.
--------------------------------------------------------------------------------
SOURCES: Apridonidze, T. The Journal of Clinical Endocrinology & Metabolism, April 2005; vol 90:
pp 1929-1935. WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS) --
Topic Overview." WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS)
-- Symptoms." News release, The Endocrine Society. WebMD Medical News: "Do You Have
Metabolic Syndrome?" Medical College of Virginia.