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Women with Polycystic Ovary Syndrome Often Have Cardiovascular Disease Risk Factors, Too

Thursday, October 10th, 2013

A study published in the Journal of Clinical Endocrinology and Metabolism highlighted the relationship between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD). Researchers noted that women with PCOS were more likely to have risk factors for CVD. They carried out a study in which evidence-based reviews were provided of studies that examined the risk relationship and to develop guidelines for lessening the risk of CVD.

The study included only other studies where PCOS patients were compared with control patients, and excluded any articles that included unclear PCOS diagnoses or unclear controls. The conclusion of the study was that women with PCOS who are also obese, smoke, or have high blood pressure or impaired glucose tolerance are at risk for CVD. Women who have PCOS and type 2 diabetes are at high risk for CVD.

PCOS is common, affecting 6-10% of women of childbearing age, and is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Other symptoms that women may notice to varying degrees include irregular menstrual periods, hirsutism, acne or other skin problems, weight gain (especially around the waist), thinning hair, pelvis pain, sleep apnea, and anxiety or depression. In young women with PCOS, there may be multiple risk factors for CVD, such as metabolic syndrome, type 2 diabetes, abdominal obesity, and high blood pressure. For these women, taking measures to prevent future CVD is an absolute necessity.

If you feel you may have PCOS, talk to your doctor about it. Your doctor will take some steps to see if you really do have PCOS or if another condition is causing your symptoms. Expect your doctor to ask you about your medical history, including your menstrual cycle and any weight changes; perform a physical exam, including blood pressure, waist size, and areas of increased hair growth; a pelvic exam, to check your ovaries for enlargement; a vaginal ultrasound, to further examine your ovaries; and blood tests to check for androgen and glucose levels in your blood.

If you do find out you have PCOS, even though there is no known cure, there are effective treatments that can help you manage your symptoms and prevent further problems. The right treatment for you will depend on your individual symptoms and whether or not you may become pregnant. Goals of treatment include lowering your risk for CVD and relieving your symptoms. A combination of treatments is the most effective route for most women.

The first line of defense against PCOS is losing weight. Eating healthfully and exercising can help you manage your symptoms with great success. Limiting sugars and processed foods will lower your blood glucose levels, improve the way your body uses insulin, and help normalize androgen levels. Even losing 10% of your body weight can make a big difference in irregular periods. If you don’t want to become pregnant, birth control pills can regulate your menstrual cycle, reduce your levels of male hormones, and help clear up your skin.

If you have diabetes, metformin is a drug your doctor may prescribe. It affects the way insulin is processed in your body and lowers male hormone production; it can also relieve many PCOS symptoms such as excessive hair growth, lowering cholesterol levels, and assisting with weight loss. It is important to note that metformin has not been approved by the FDA for treating PCOS, but it is approved and effective at treating diabetes, and studies show that it does, indeed, help with many common symptoms of PCOS.

– Yvonne S. Thornton, M. D., M. P. H.