Women with this condition are at risk for multiple morbidity and drug use in late childbearing age.
At 46, women with PCOS have an increased risk of T2D, depression, migraine, hypertension, tendonitis, osteoarthritis. Photo: Shutterstock.
Polycystic ovary syndromeThat is PCOS by its acronym, it is the most common endocrine disorder in women of childbearing age, with a prevalence of 5% to 18%.
The present study focused on assessing morbidity, self-reported symptoms, medication use, and health service employment among 46-year-old women with PCOS and in controls without PCOS.
The PCOS used to be considered primarily a breeding condition; however, it is now commonly accepted that women PCOS are at high risk for metabolic disorders, including obesity, glucose intolerance, type 2 diabetes mellitus (T2DM), metabolic syndrome and possibly cardiovascular events.
Additionally, it has been shown that women with PCOS they have a higher risk of psychological morbidity, 10, 11 asthma, 12 and migraine. 13
Surprisingly, only a few studies have systematically assessed the comorbidity usually in women with PCOS.
This should be a high priority given the high cost to society resulting from morbidity related to PCOS. For example, it has been estimated that T2DM linked to PCOS alone represents an annual cost of £237 million ($310 million) in the UK15 and $1.77 billion in the US
It often remains underdiagnosed and therefore underrepresented in patient and national registries, limiting the capture of comorbidities. Previous studies have reported mostly hospital diagnoses without symptom data. Furthermore, attention has focused primarily on women in their early or middle reproductive years, and data on morbidity at the end of reproductive life are scarce.
material and methods
The study population was from the Northern Finland birth cohort of 1966 and consisted of women who reported amenorrhea and hirsutism at age 31 and/or diagnosed with PCOS at age 46 (n=246) and controls with no symptoms or diagnosis of PCOS (n=1573), referred to as women without PCOS.
The primary outcome measures were self-reported data on symptoms, diagnosed illnesses, and use of medications and health care services at age 46.
Overall morbidity risk increased by 35% and medication use by 27% compared to women without PCOSand the risk remained after adjusting for body mass index.
The most common diagnoses in women PCOS these were migraine, hypertension, tendinitis, osteoarthritis, fractures and endometriosis.
The PCOS it was also associated with autoimmune diseases and recurrent upper respiratory tract infections and symptoms. Interestingly, health care service employment did not differ between study groups after adjusting for body mass index.
Graphic: Intramed.
women with PCOS they are fraught with multiple morbidity and increased drug use, regardless of body mass index.
This population-based follow-up study illustrates the elevated risk of multimorbidity and self-reported poor health in women with PCOS until the last years of reproduction.
We show that the PCOS is associated with an increased risk of several diseases and symptoms, some of which are linked, for the first time, to PCOS.
Some of the differences in disease risk, and in particular medication use, were due to higher BMI, indicating that the PCOS, by itself, may not always be the primary cause of some of the comorbidities. However, the median morbidity score for women with PCOS with a BMI of 25 kg/m2 or more was similar to that of women with PCOS and less weight.
More studies are warranted on the pathogenetic mechanisms of comorbidities in the PCOSbecause a high BMI does not seem to be solely responsible for the increase in morbidity.
At age 46, women with PCOS had an increased risk of T2DM, depression, migraine, hypertension, tendonitis, osteoarthritis (particularly of the knee, back or shoulder), fractures, endometriosis, gestational diabetes and preeclampsia, although after adjustments, the risks of T2DM, depression, diabetes and preeclampsia no longer increased significantly.
Tendonitis has not been linked to PCOS before; however, musculoskeletal diseases in general and osteoarthritis are more common in affected women. The risk of fracture in women with PCOS it is debatable. In a Danish population, fractures were not more general, unlike a Taiwanese study as well as ours.
Recently, we reported higher vitamin D levels in the same population with PCOS; however, markers of bone formation and bone mineral density appear to be decreased in the PCOS. Further studies should be conducted in women with PCOS with different phenotypes to separate the role of hyperandrogenism and metabolic disorders.
Airway problems were more common in women PCOS. Women reported wheezing cough, recurrent respiratory infections, and atopic, infantile, or allergic eczema more often than controls. Evidence of higher prevalence of various respiratory infections and diseases in women PCOS increase.
The mechanisms underlying these disorders are unknown, but increased low-grade systemic inflammation or hyperandrogenism may be a predisposing factor.
The higher prevalence of eczema is a new finding, although certain dermatological manifestations, such as hidradenitis suppurativa, have previously been associated with PCOS.
This is the first study to assess self-reported symptoms related to infections and autoimmune diseases in women with PCOS. Affected women reported more frequent recurrent infections, including pneumonia, ear infections and colds, and greater susceptibility to infections than controls at age 46.
In addition, symptoms related to autoimmune diseases were more common in women PCOS than in controls. These findings are supported by a recent systematic review and meta-analysis featuring women PCOS not only with an increased risk of autoimmune thyroid disease, but also with an increased risk of asthma.
There is only one previous population-based study of drug use in women PCOS. Although the increase in medication use in our study was self-reported, the medication profile was similar to that reported in the Danish registry-based study. Medications used to treat diseases of the digestive tract and metabolism were more common among polycystic ovary syndrome.
women with PCOS reported morbidities, symptoms, and increased medication use more frequently than controls. Additionally, women with PCOS they rated their health as poor or very poor almost three times more often than controls, consistent with our previous finding.
Source consulted here.