A Cause of Female Infertility May Up Heart Risk

Researchers See Link Between PCOS and Metabolic Syndrome

Reviewed by Brunilda Nazario, MD on April 06, 2005
From the WebMD Archives

April 6, 2005 -- One of the most common causes of female infertility -- polycystic ovary syndrome (PCOS) -- may raise the risk of heart disease.

PCOS is a hormone imbalance that interferes with women's normal ovulation. Nearly 2 million U.S. women could be affected, say doctors from the Medical College of Virginia in The Journal of Clinical Endocrinology & Metabolism. These women have increased rates of metabolic syndrome, they find.

"These findings support the idea that PCOS should be considered a general health disorder with serious public health implications," they write. They encourage doctors to screen PCOS patients for metabolic syndrome, a cluster of abnormalities that raises the risk of heart disease and diabetes.

Common Problem

The study of 106 women with PCOS showed that 43% also had metabolic syndrome. Metabolic syndrome was twice as common in these women as in women of the same age without PCOS, says the study.

Because PCOS affects up to 10% of the 50 million reproductive-aged women in the United States, if the prevalence of metabolic syndrome in PCOS is approximately 40%, then nearly 2 million women may be affected with both PCOS and the metabolic syndrome, write the researchers.

Symptoms of PCOS

Symptoms of PCOS include:

  • Infertility
  • Eight or fewer menstrual periods in one year
  • High levels of the male sex hormone testosterone
  • Excess of thick hair growth on the face, chest, back, stomach, thumbs, or toes
  • Male pattern baldness
  • Abnormal vaginal bleeding
  • Increased risk of uterine cancer
  • Skin problems such as acne, dandruff, oily skin, and dark skin patches
  • Depression or mood swings

PCOS can start gradually. Many women (but not all) will have numerous small cysts on their ovaries. Some women have other symptoms but do not have evidence of ovarian cysts.

To diagnose PCOS, doctors look at many possible causes of excess and abnormal production of male hormones. Medications and lifestyle adjustments, such as weight loss in overweight women, are usually used to treat the metabolic problems associated with PCOS.

Insulin resistance is the hallmark of PCOS, say the researchers. The body makes insulin to control blood sugar.

About Metabolic Syndrome

Insulin resistance is also linked to metabolic syndrome, which can affect men or women. Patients have at least three of the following traits:

Are the Conditions Connected?

Participants with PCOS and metabolic syndrome had higher testosterone levels than those without metabolic syndrome.

They also showed signs of the metabolic syndrome more frequently and may have had more severe insulin resistance.

Age and obesity didn't change the results. Though the women were 20-39 years old, their prevalence of metabolic syndrome was typical of women almost twice their age.

"The prevalence rate of metabolic syndrome in our women with PCOS was comparable to the 44% rate reported for women aged 60-69 in the general population," write John Nestler, MD, and colleagues.

Nestler leads the Medical College of Virginia's division of endocrinology and metabolism. He has devoted much of his career to studying PCOS.

Study's Limits

The study included a relatively small number of PCOS patients, and the researchers didn't have all the data they wanted, since the study was retrospective.

Waist measurements -- a component of metabolic syndrome -- weren't known for all the women, so BMI (body mass index) was used instead. Formal analysis of excess hair patterns in women with PCOS weren't available, and insulin resistance wasn't directly measured.


Possibly, some women may have misremembered their menstrual irregularities or family medical histories, say the researchers.

Still, they say the findings are significant since the women weren't handpicked and the rate of metabolic syndrome was high.

WebMD Health News


SOURCES: Apridonidze, T. The Journal of Clinical Endocrinology & Metabolism, April 2005; vol 90: pp 1929-1935. WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS) -- Topic Overview." WebMD Medical Reference from Healthwise: "Polycystic Ovary Syndrome (PCOS) -- Symptoms." News release, The Endocrine Society. WebMD Medical News: "Do You Have Metabolic Syndrome?" Medical College of Virginia.

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