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Unwanted hair, acne, being overweight, having problems with menstruation and getting pregnant, and – as scientists have recently shown – depression and other mental disorders. Women with polycystic ovary syndrome (PCOS) suffer from bothersome ailments, but doctors often do not treat them with the proper attention. Currently, scientists are studying this disease more and more closely. But will it contribute to better specialist patient care?
Scientists from the Neuroscience and Mental Health Research Institute at Cardiff University presented the new research results at the UK Endocrine Society’s annual conference on November 6-8 in Harrogate.
Researchers have confirmed previous observations that PCOS – the most common hormonal disorder in women of childbearing age, affecting up to 15 percent. of them – may have a negative impact on the mental health of patients.
Scientists under the supervision of Dr. Aleda Rees analyzed the medical data of over 17. women diagnosed with PCOS. They monitored their health for six months. The results were compared with information for women without the condition with a similar age, body mass index (BMI), and place of residence.
Depression and more
They found that patients with PCOS were more often diagnosed with mental illness, including depression, anxiety and bipolar disorder. – The impact of PCOS on women’s mental health is underestimated. Our work indicates that these patients should be screened for mental disorders during checkups, said Dr Rees. Thanks to this, they can be treated earlier, which will improve their health and quality of life.
Interestingly, the children of women with polycystic ovary syndrome were more likely to have autism or ADHD (attention deficit hyperactivity disorder). Why? For now, scientists cannot explain whether it is related to too high testosterone levels in women with PCOS or to the genetic conditions underlying this disease syndrome.
The team of dr. Reesa plans further research that will explain the influence of genetic factors on both the predisposition to PCOS and to mental disorders in these patients, as well as to neurodevelopmental disorders in their offspring.
Where does it start?
The causes of this common disease are unknown, but it is known that women with PCOS have too high levels of male sex hormones – androgens, an incorrect ratio of two fertility-regulating hormones – luteinizing hormone (LH) to follicle stimulating hormone (FSH) and so-called insulin resistance (i.e. decreased tissue sensitivity to insulin) and elevated insulin levels.
As a result, women with PCOS have, inter alia, enlarged cystic ovaries, infrequent or absent ovulations, irregular periods, problems getting pregnant, acne, excessive facial and body hair, and quite often overweight or obese.
PCOS is not completely curable, but proper treatment can alleviate its symptoms and increase your chances of getting pregnant and having a baby. But fighting the disease is not easy.
Hormone storm and nervous breakdown
Although patients with polycystic ovary syndrome are more prone to nervous breakdowns, they rarely visit psychiatrists. Could this change? – It would be absurd to consult psychiatric patients with PCOS. However, the gynecologist leading the patient should pay attention to the psychological aspects of health and if he sees disturbing symptoms, such as prolonged sadness, anxiety, irritability, insomnia, which significantly impair functioning, he should refer him to a psychiatrist – says Prof. Dominika Dudek from the Jagiellonian University, author of the book “Psychiatry in heels”.
Prof. Dudek also points out that some drugs used in psychiatry may have side effects, such as menstrual disorders and weight gain, which may hinder the diagnosis and treatment of PCOS.
In turn, prof. Anita Olejek, a provincial consultant in the field of obstetrics and gynecology in the Silesian Province, notes that the work of the British is one of a dozen published this year devoted to the relationship between PCOS and mental health. This shows that the world of science has appreciated the problem and is now giving it due attention.
– When I started work, the disease was identified by obvious, severe symptoms. However, apart from the surgical treatment of the most severe cases, we could not offer the patients much. Meanwhile, unwanted hair for some women was so troublesome that there were suicides for this reason – recalls prof. Oil.
Everything will be fine?
Today the situation has changed dramatically. There are many types of PCOS, many of them being mild, with only some or not very severe symptoms.
The causes of the disease are still being investigated. For example, we know that disturbances can originate in utero – androgens produced by the fetus can affect the central nervous system and affect the disorder later in life.
As a girl grows up, she develops insulin resistance and obesity. So it begins to differ in appearance from the group of its peers. It is the cause of mood and personality disorders, depression and alienation from the group. The susceptibility to mood breakdowns lasts practically all life, because this is the action of androgen hormones.
In adulthood, another problem arises – a woman’s fear of having children. – There is a perception that women with PCOS have problems getting pregnant. However, today there are many options for drug treatment, restoring ovulation and enabling pregnancy. Medicine has made great progress and we can help almost all patients in this area – says prof. Oil.
As emphasized by prof. Oil, many studies confirm that women with PCOS require a multidisciplinary perspective. It should cover not only hormone treatment, but also diet. Simply limiting the amount of calories you eat is not enough. The specialist knowledge of a dietitian today and rigor come to the rescue – eating strictly defined products in the right order and at the right time, which is almost impossible without professional support.
Since adipose tissue secretes many harmful hormones, losing weight results in a great improvement in the condition, as well as reducing hair and acne.
Therefore, as emphasized by prof. Oil – in this disease, diagnosis alone is definitely not enough for patients. It is important to explain how to deal with problems and to undergo constant medical care. And that’s missing. Women reach for information on the Internet and despair because it spreads a mini black image in front of them, threatening, for example, with infertility or the risk of endometrial cancer.
Psychologists could help, but there are no such in hospital gynecology departments.
Support groups, including internet ones, can be a form of help. – The most important thing for women to be aware of this, you can effectively fight against unwanted hair, lack of ovulation or overweight. You cannot give up and break down, because with PCOS you can function fully normally – adds prof. Oil.