Women with this disease are at risk for multiple morbidity and drug use in late childbearing age.
At the age of 46, women with PCOS are at increased risk of T2DM, depression, migraine, hypertension, tendinitis, osteoarthritis. Photo: Shutterstock.
Polycystic ovary syndromeeither PCOS by its acronym, it is the most frequent endocrine disorder in women of reproductive age, with a prevalence of 5% to 18%.
The present study focused on assessing morbidities, self-reported symptoms, medication utilization, and health care service employment in 46-year-old women with PCOS and in controls without PCOS.
The PCOS used to be considered primarily a reproductive condition; however, it is now commonly 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.
Furthermore, 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 evaluated the comorbidity generally 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 related to PCOS alone carries 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 reported mainly hospital diagnoses with no data on symptoms. In addition, attention has focused primarily on women in their early or middle reproductive years, and morbidity data in late childbearing years are sparse.
Material and methods
The study population came from the 1966 Northern Finland Birth Cohort and consisted of women who reported amenorrhea and hirsutism at the age of 31 years and/or a diagnosis of PCOS at age 46 years (n = 246) and controls without symptoms or diagnosis of PCOS (n = 1573), referred to as women without PCOS.
The main outcome measures were self-reported data on symptoms, diagnosed illnesses, and utilization of medications and health care services at age 46 years.
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 prevalent diagnoses in women with PCOS they 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, employment of health care 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-reported health among women with PCOS until the last reproductive years.
We show that the PCOS is associated with an increased risk of several diseases and symptoms, some of them related, for the first time, to the PCOS.
Some of the differences in disease risk, and especially medication use, were due to high BMI, indicating that the PCOS, per se, may not always be the main 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 pathogenic mechanisms of comorbidities in the PCOSsince high BMI does not seem to be the only one responsible for the increased morbidity.
At age 46, women with PCOS had an increased risk of T2DM, depression, migraine, hypertension, tendinitis, osteoarthritis (especially in the knee, back, or shoulder), fractures, endometriosis, gestational diabetes, and preeclampsia, although after adjustments, the risks of T2DM, depression, gestational 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 among women with PCOS it is debatable. In a Danish population, fractures were not more general, in contrast to a Taiwanese study as well as ours.
Recently, we have reported higher levels of vitamin D 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 among women with PCOS with different phenotypes to segregate the role of hyperandrogenism and metabolic disorders.
Respiratory tract problems were more common in women with PCOS. Women reported wheezing cough, recurrent respiratory infections, and atopic, infantile, or allergic eczema more often than controls. Evidence of a higher prevalence of various infections and respiratory diseases in women with PCOS is increasing.
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 novel finding, although some dermatological manifestations, such as hidradenitis suppurativa, have been previously related to PCOS.
This is the first study to assess self-reported symptoms related to infections and autoimmune diseases among women with PCOS. Affected women more frequently reported recurrent infections, including pneumonia, ear infections, and common colds, and higher susceptibility to infections than controls at age 46 years.
In addition, symptoms related to autoimmune diseases were more common in women with PCOS than in the 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 register-based study. Medications used to treat alimentary tract and metabolic diseases were more frequent in the polycystic ovary syndrome.
women with PCOS reported morbidities, symptoms, and increased medication use more frequently than controls. Furthermore, women with PCOS they rated their health as poor or very poor almost three times more often compared to controls, in line with our previous finding.
Source consulted here.