Women with this disease are at risk of multiple morbidity and drug use in late childbearing years.
At age 46, women with PCOS are at increased risk of T2DM, depression, migraine, hypertension, tendinitis, osteoarthritis. Photo: Shutterstock.
Polycystic ovary syndromeor PCOS according to its abbreviation, it is the most common endocrine disorder in women of reproductive age, with a prevalence of 5% to 18%.
The current study focused on assessing morbidity, self-reported symptoms, medication use, and health service employment in 46-year-old women with PCOS and in controls without PCOS.
The PCOS was considered primarily a reproductive condition; however, it is now generally accepted that women with PCOS are at high risk for metabolic disorders, including obesity, glucose intolerance, type 2 diabetes mellitus (T2D), metabolic syndrome, and possibly cardiovascular events.
In addition, it has been proven 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 evaluated comorbidity usually in women with PCOS.
This should be a high priority given the high cost to society of the morbidity associated with PCOS. For example, it has been estimated that T2DM is associated with PCOS alone brings in annual costs of £237 million ($310 million) in the UK15 and $1.77 billion in the US
It often remains underdiagnosed and therefore underrepresented in patient registries and national registries, limiting the capture of comorbidities. Previous studies mainly reported hospital diagnoses without symptom data. In addition, attention has focused primarily on women in their early or middle reproductive years, and data on morbidity in the late childbearing years are scarce.
materials and methods
The study population came from the Northern Finland birth cohort in 1966 and consisted of women who reported amenorrhea and hirsutism at age 31 years and/or diagnosis PCOS aged 46 years (n = 246) and controls without symptoms or diagnosis of PCOS (n = 1573) referred to as women without PCOS.
Primary outcome measures were self-reported data on symptoms, diagnosed illnesses, and use of medications and health services at age 46 years.
Overall risk of morbidity 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 with PCOS they were migraine, hypertension, tendinitis, osteoarthritis, fractures and endometriosis.
The PCOS it is also associated with autoimmune diseases and recurrent upper respiratory tract infections and symptoms. Interestingly, employment in health services did not differ between study groups after adjusting for body mass index.
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 high risk of multimorbidity and poor self-rated health among women with PCOS until the last reproductive years.
We show that PCOS is associated with an increased risk of several diseases and symptoms, some of which have been first associated with PCOS.
Some of the differences in disease risk and especially drug use are due to high BMI, indicating that PCOSitself may not always be the root cause of some of the co-morbidities. However, the mean morbidity score in women with PCOS with a BMI of 25 kg/m2 or more is similar to that of women with PCOS and less weight.
More studies are needed on the pathogenic mechanisms of comorbidities in PCOSas high BMI does not appear to be solely responsible for increased morbidity.
At 46 years old, women with PCOS had an increased risk of T2DM, depression, migraine, hypertension, tendinitis, osteoarthritis (especially of the knee, back or shoulder), fractures, endometriosis, gestational diabetes and preeclampsia, although after adjustment the risks of T2DM, depression, gestational diabetes and preeclampsia were already does not increase significantly.
Tendinitis is not associated with PCOS before; however, musculoskeletal disorders in general and osteoarthritis are more common in affected women. The risk of fractures among women with PCOS this is debatable. In the Danish population, fractures are not more common, in contrast to a Taiwanese study as well as ours.
We recently reported higher vitamin D levels in the same population with PCOS; however, markers of bone formation and bone mineral density appear to be reduced in PCOS. Further studies should be conducted among PCOS women with different phenotypes to disentangle the role of hyperandrogenism and metabolic disorders.
Respiratory problems are more common in women with PCOS. Women reported wheezing, recurrent respiratory infections, and atopic, infantile, or allergic eczema more often than controls. Evidence for a higher prevalence of various infections and respiratory diseases in women with PCOS increases.
The mechanisms behind these disorders are unknown, but increased low-grade systemic inflammation or hyperandrogenism may be predisposing factors.
The higher prevalence of eczema is a new finding, although some 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 among women with PCOS. Affected women more often reported recurrent infections, including pneumonia, ear infections, and the common cold, and greater susceptibility to infections compared with controls aged 46 years.
In addition, symptoms related to autoimmune diseases are more common in women with PCOS than in controls. These results are supported by a recent systematic review and meta-analysis presenting women with 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 medication use among women with 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. Medicines used to treat digestive and metabolic diseases are more common in polycystic ovary syndrome.
women with PCOS reported illnesses, symptoms, and increased medication use more often than controls. In addition, women with PCOS they rated their health as poor or very poor almost three times as often as controls, consistent with our previous finding.
Source consulted here.