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Women With PCOS At Double The Risk For Hospitalizations, Developing Other Conditions

July 10, 2015 – Experts Down The Hall – Ronald Feinberg

Source: The Journal Of Clinical Endocrinology & Metabolism

Researchers from Australia found patients who had polycystic ovary syndrome were hospitalized more than twice as often as women who did not have the condition, and are at further risk of developing other medical complications, according to a recent study.

Polycystic ovary syndrome (PCOS) is a condition that causes a hormone imbalance in women, which can lead to irregular or missed periods, unwanted hair growth, infertility, weight gain, acne, and other symptoms. Other comorbidities—the presence of other chronic diseases together with PCOS—commonly include conditions linked to insulin resistance, such as diabetes and cardiovascular disease.

In the study, researchers analyzed the medical records of 2,556 patients with PCOS between 1997 and 2011. They were matched against the records of 25,660 patients who did not have PCOS. Hospitalizations in each group were followed until the patients were mean 35.8 years of age.

The National Institutes of Health estimates that between 5% and 10% of women are affected by PCOS in the United States.

Patients with PCOS were at an increased risk of hospitalization due to heavy bleeding, infertility, and pregnancy loss. The researchers noted these patients were also more likely to have endocrine, circulatory and respiratory conditions as well as diseases of the musculoskeletal system. Other risk factors for PCOS included mental disorders such as stress, anxiety, and depression. Patients also had an elevated risk of developing endometrial cancer.

The National Institutes of Health estimates that between 5% and 10% of women are affected by PCOS in the United States. While the origins of PCOS are not well understood, experts believe genetics and environment play a strong role in developing the condition.

From Our Expert, Dr. Ronald Feinberg

“The key value of PGS and CCS is our ability to predict which embryo or embryos have a normal complement of 46 chromosomes prior to uterine transfer. When a normal mature egg containing 23 chromosomes is fertilized with a normal sperm (containing another set of 23 chromosomes), an embryo with 46 chromosomes can develop.”

The results of this study are not surprising given that the incidence of insulin-related diseases, such as obesity and diabetes, has risen dramatically over the last century. While our genetics have not changed for thousands of years, what has changed is the addition of stressors to daily life, a transition to a more sedentary lifestyle, and the change in the quality and quantity of healthy food choices.

Historically, women with PCOS inherited a great set of genes that encouraged a low-calorie metabolic life and provided their ovaries with an abundance of insulin and gonadotropin-sensitive follicles. But today’s fast-paced, modern lifestyle has caused these efficient genes to go into metabolic overdrive, and women with PCOS are left with a disease that instead causes numerous issues affecting their health, fertility, and physical appearance.

These problematic issues can be treated by realizing the symptoms associated with PCOS are linked. PCOS is similar to Syndrome X, a cluster of high-insulin metabolic symptoms that are significant risk factors for obesity, diabetes, hypertension, and coronary artery disease. In the 1980s, Dr. Gerald Reaven, a distinguished professor emeritus at Stanford University, coined the name Syndrome X to describe this constellation of symptoms.

But while the insulin-lowering treatments recommended by doctors for Syndrome X could prove beneficial to women, they do not address the specific health issues women will experience during their reproductive years. For that reason, I conceived of the name Syndrome O to describe the connection between Syndrome X, insulin, and the female reproductive system.

The hallmarks of Syndrome O are overnourishment, ovarian confusion, and ovulation disruption. Overnourishment describes the metabolic state of women for whom the wrong quantity and quality of calories are being consumed; ovarian confusion refers to the reaction of the ovaries when exposed to large quantities of insulin hormones; ovulation disruption is what occurs when insulin signals in a woman’s body are so out of balance that they prevent ovulation.

The goal of most women with Syndrome O who come to our center is pregnancy. The key to managing Syndrome O lies in finding an advocate who will encourage women to take control of their overall wellness to optimize their chance for pregnancy. However, many women with Syndrome O have trouble maintaining a healthy weight despite eating well and making good lifestyle choices, and my advice for these women is not to give up. An enthusiasm for health and fitness is needed to reach these goals, but it is difficult to maintain such enthusiasm alone. Our Clinician Director of Fertility Wellness, Rhonda Wright, has been successful in creating individualized wellness plans and guiding many of our patients to better reproductive health.

With over two-thirds of the adult U.S. population today classified as overweight or obese, there is no more appropriate time to revisit Syndrome O and its impact on women. Through persistence and making continually good choices about their health, women with Syndrome O will meet their goals, whether that is overcoming challenges with weight, improving appearance, or having a healthy baby.

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