Health Science Reviews

by Kaylene Baron

Polycystic Ovarian Syndrome (PCOS) is a disease that results in enlarged ovaries due to the ovaries being covered with cysts [2]. These cysts cause hormonal imbalances. The symptoms of PCOS will vary in degree from one person to another. But, for the most part, these are symptoms: being overweight or obese, few or no periods, irregular menstrual cycle, prone to acne, hirutism (excess body hair) on the face, breasts, insides of the legs as well as mood swings. What makes PCOS such a devasting disease, is that a woman’s fertility is questionable. (Obviously seeing that it is the ovaries we are talking about here). This is due to her irregular menstrual cycle and also no ovulation. This makes conception (falling pregnant) as well as pregnancy (being able to carry the baby to term-in other words, for the full 9 months) difficult [2]. But for me, what makes PCOS devasting is the fact that these hormonal imbalances also have an impact on your metabolism. This increases a woman’s chance of developing diabetes and heart disease [2]. This will be the focus of this blog post.  

To put this situation in a South African context, let me give you some statistics. According to an article in the South African Journal of Obstetrics and Gynaecology, [3]. the condition affects 15–20% of women in their childbearing years and is also linked to 40% of female infertility cases in South Africa. To date, there is no set cause for PCOS much less a cure. I am going to discuss an article with you that investigated the risk of PCOS patients having diabetes [1].

They performed this study by doing the following: Subjects were recruited from the diabetes clinic population (2500 patients) of The Middlesex Hospital. Various criteria were used to determine who is eligible for this study, this total later came down to 38. In subjects with regular menstrual cycles, studies were carried out during the follicular phase (i.e., the stage where menstruation takes place followed by the maturing of the egg until ovulation). Investigations were performed at random in those with marked oligomenorrhoea or amenorrhoea. Body mass index was calculated as weight/height² (kg/m²). The waist circumference was taken at the level of the umbilicus, the hip circumference was taken at the level of the pubis symphysis to determine the waist/hip ratio. The pelvic ultrasounds were performed to confirm if a woman has polycystic ovaries or not. Fasting blood samples were drawn to test the levels of the various reproductive hormones as well as insulin levels [1].

From the results obtained, eighty-two per cent (31 out of 38) of the women studied had ultrasonographic evidence of polycystic ovaries. The influence of insulin on ovarian function in the group of women with PCO was further analysed using correlations between metabolic parameters and serum androgen concentrations. Body mass index was positively correlated with leptin and total testosterone. Ovarian volume was positively correlated with fasting insulin, androstenedione, total testosterone, body mass index, waist: hip ratio and negatively associated with SHBG [1].

From this study, we can conclude that women with PCOS have higher androgens (male hormones) than women with no PCOS. The impact of this results in a higher BMI and a higher waist: hip ratio. A woman who has uncontrolled weight gain ends up having heart disease and insulin resistance which later gives rise to diabetes.

References:

1. Conn, JJ., Jacobs, HS., and Conway, GS. 2000. The prevalence of polycystic ovaries in women with type 2 diabetes mellitus. Clinical endocrinology, 52(1):81-86
2. Glenville, M. 2001. The Natural Health Handbook for Women: The complete guide to women’s health problems and how to treat them naturally. London: Piatkus  
3. Page, S. 2019. Life healthcare: Get informed about Polycystic Ovary Syndrome.