About 10% of women have polycystic ovary syndrome (POS), a problem in which small pockets of fluid develop around the edge of the ovaries, where human egg cells are formed. Irregular periods, ovulation problems, weight gain, and excessive hair growth are the symptoms of this disease. It can affect hormone levels, menstrual periods, ovulation, and fertility.
The bad news first:
Polycystic ovaries may predispose women to have trouble with pregnancy. The prestigious British Medical Journal published research on the topic from the Karolinska Institutet and Karolinska University Hospital in Stockholm, derived from 12 years of Swedish birth records. The Swedish scientists discovered that compared to women without the condition, those diagnosed with polycystic ovary syndrome were more often obese and more often used assisted reproductive technology like in vitro fertilization.
The most important finding, though, linked POS with a 45% risk of pregnancy hypertension and twice the risk of diabetes in pregnancy and premature birth. “These women may need increased surveillance during pregnancy and childbirth. Future research would benefit from focusing on glucose control, medical treatment and hormonal status among women with polycystic ovary syndrome during pregnancy.”
Good news, sort of:
Some of the mystery about POS has been solved. Many women with polycystic ovary syndrome have a parent or parents with heart disease. A report from the University of Adelaide, Australia, came out recently in the online journal PLoS ONE.
700 women and their parents were studied. The mothers of women with POS were more likely to have cardiovascular disease, and almost twice as likely to have high blood pressure, than mothers without these circulatory problems. Fathers of women with POS also had more than twice the occurrence of heart disease, and over four times as frequent strokes, than fathers of other women. Thus polycystic ovary syndrome may be related to a genetic susceptibility to chronic heart disease.
And the best news last:
Sarah Berga, MD, former Chair of the Department of Gynecology and Obstetrics at the Emory University School of Medicine and an expert in reproductive endocrinology, offered several ideas about why the polycystic condition may have evolved. Dr. Barga spoke at an American Physiological Society meeting at the University of Mississippi in Jackson.
Her topics were cardiovascular disease and POS, the interest of the Australian researchers, and sugar metabolism. Barga linked the ovulation problem of women with POS to an earlier time. Primitive women may have adapted to periods of famine by increasing their insulin resistance in order to conserve precious calories, Barga said. This extended their period of conception into the future, when food might be plentiful again.
“P[C]OS might have been a good thing to have in times of food scarcity because it allowed the window of fertility to be extended and it allowed women to survive and reproduce in low fuel environments. Today we have calories all around us, and yet the body’s possible adaptation to another time still remains for some women,” said Berga. “One way to look at P[C]OS is as a past adaptation gone astray.” She also linked the syndrome to stress sensitivity, in that POS allows for reproduction in stressful times, and stress sensitivity turns off reproduction during these conditions.
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