Serum testosterone levels decrease in middle age in women with the polycystic ovary syndrome

The role of vitamin D in polycystic ovary syndrome

INTRODUCTION: Polycystic ovary syndrome (PCOS), affecting 11–13% of women globally, is associated with multiple health complications, including increased risk of endometrial cancer. However, the risks for breast and ovarian cancers remain unclear. This study evaluates the cancer risk profiles in women with PCOS, comparing those of reproductive age (RA; 15–44 years) with post-reproductive age (P-RA; 45 years and older). METHODS: We conducted a retrospective analysis using the TriNetX database of deidentified medical records on June 30, 2024. Cohorts of women with and without PCOS were stratified by age to assess PCOS effect on endometrial, breast, and ovarian cancer risks. Propensity matching was used to account for confounders: age/race/ethnicity. A value of P≤.05 was deemed significant. RESULTS: Among women with PCOS (n=98,239), there was a significantly higher relative risk (RR) of endometrial cancer (RR 2.39) and significantly lower RR of breast cancer (RR 0.85), compared to women without PCOS (n=98,239), and no significant difference in ovarian cancer risk. P-RA women with PCOS had a significantly higher RR of endometrial, breast, and ovarian cancers compared to RA women with PCOS (RA [n=37,988] versus P-RA [n=37,988]: endometrial RR 0.424; ovarian RR 0.263; breast RR 0.174). CONCLUSIONS/IMPLICATIONS: This study confirms the reported increased risk of endometrial cancer in women with PCOS and demonstrates a higher risk for all three cancer types in P-RA women with PCOS. The findings support enhanced cancer screening for women with PCOS, particularly those who are post-reproductive age. Further research is needed to understand the hormonal influences on cancer risk in this population.

Increased monocyte chemoattractant protein-1 levels indicating early vascular damage in lean young PCOS patients

PCOSt: A non-invasive and cost-effective screening tool for polycystic ovary syndrome

BackgroundLifestyle intervention is the first-line treatment for PCOS. Numerous studies have investigated the effect of various lifestyle factors, including dietary habit, smoking, and alcohol consumption on PCOS women. These studies have found that such factors may be associated with physiological parameters such as androgen, and emotional states like anxiety or depression. Smoking, a harmful lifestyle habit widely recognized to contribute to various diseases, has also been found to be related to PCOS. Current research has not adequately compared the effects of smoking with other lifestyle habits on PCOS, and there is little mention of its relationship with the emotional states of patients with PCOS. To further elucidate the association between smoking and other lifestyle factors with clinical symptoms in patients with PCOS, we conducted a cross-sectional evaluation using data from Peking University Third Hospital, with a special focus on analyzing smoking habits and comparing it with a variety of lifestyle factors.MethodsThis cross-sectional study included 601 PCOS women and 184 healthy controls who underwent physical examinations, hormone profiles and psychological measures. We assessed the association between smoking and the clinical symptoms in PCOS women.ResultsWe found a significant correlation between smoking and the degree of depression in PCOS women among the three emotional states: anxiety, depression, and stress. Smoking was also significantly associated with testosterone level in PCOS participants, suggesting that PCOS women who smoke exhibited more severe depressive symptoms and higher testosterone level. In addition, compared to the control group, PCOS women had notably higher testosterone (T) and luteinizing hormone (LH) levels. Smoke and alcohol were statistically significantly more common in women with PCOS than the Control.ConclusionWomen with PCOS who smoke were found to have elevated testosterone levels and more severe depression. These findings suggest that clinicians should monitor smoking women with PCOS for symptoms of depression and assess their hyperandrogenic status.

Polycystic Ovarian Syndrome (PCOS), a prevalent endocrine disorder among women of reproductive age and is frequently accompanied by metabolic disturbances that considerably elevate long-term cardiovascular risk. Among these abnormalities, dyslipidemia is one of the most common and clinically significant; however, evidence from sub-Saharan Africa, particularly Nigeria, remains limited. This study therefore evaluated lipid profile alterations and their clinical significance, with a focus on their contribution to metabolic and cardiovascular disease risk among women with PCOS in Kogi State, Nigeria. A cross-sectional analytical design was employed, involving 110 women diagnosed with PCOS and 40 age-matched controls without PCOS to make a total of 150 samples. Fasting blood samples were obtained for the assessment of lipid parameters, while anthropometric measurements were recorded to calculate cardiometabolic indices, including the Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP). Statistical analyses comprised group comparisons and correlation analyses to explore associations between lipid parameters and adiposity-related indices was employed. Women with PCOS exhibited a significantly more atherogenic lipid profile than controls, characterized by elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), alongside significantly reduced high-density lipoprotein cholesterol (HDL-C). Notably, the mean HDL-C level was markedly lower in the PCOS group (1.14 ± 0.39 mmol/L) compared with controls (1.47 ± 0.21 mmol/L; p < 0.001), consistent with the characteristic dyslipidemia which is associated with insulin resistance and hyperandrogenism in PCOS. Correlation analyses revealed that TG levels were moderately and positively associated with both body mass index (BMI) (r = 0.420, p < 0.001) and waist circumference (WC) (r = 0.455, p < 0.001), whereas HDL-C display significant inverse correlations with BMI (r = ?0.315, p = 0.001) and WC (r = ?0.340, p < 0.001). In contrast, LDL-C demonstrated no statistically significant association with BMI or WC. As expected from lipid physiology, total cholesterol showed a strong positive correlation with LDL-C (r = 0.835, p < 0.01), while LDL-C was moderately inversely correlated with HDL-C (r = ?0.548, p < 0.01). BMI also correlated positively with TC (r = 0.413, p < 0.01) and LDL-C (r = 0.546, p < 0.01), and negatively with HDL-C (r = ?0.402, p < 0.01), strengthening the role of adiposity in lipid dysregulation. LAP, an index derived from waist circumference and triglycerides, demonstrated a very strong positive correlation with TG (r = 0.720, p < 0.01), underscoring its sensitivity as a marker of visceral fat–related dyslipidemia. Generally, dyslipidemia particularly elevated TC, LDL-C, and TG was highly prevalent among women with PCOS in Kogi State, Nigeria and was closely associated with indices of visceral adiposity and elevated markers of myocardial injury or stress (cTnI, CK-MB, and myoglobin). These findings indicate a substantial burden of subclinical cardiometabolic risk among women with PCOS in this population. Incorporating simple, non-invasive adiposity indices such as VAI and LAP alongside with conventional lipid profiling may improve early risk categorization. Routine cardiometabolic screening and targeted preventive interventions are therefore recommended to extenuate the progression to expressed cardiovascular disease in women with PCOS.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, affecting 4.8 % to 18.6 % of women of reproductive age. Between 10 and 19 years of age, PCOS occurs in 3.39 % to 8.03 % of adolescents. Confirmation of diagnosis in adolescent age is difficult because manifestations of PCOS are similar to normal puberty signs (e. g., irregular menstrual cycle, acne, etc.). New evidence-based guidelines have been issued in 2018 highlighting the diagnostic criteria for establishing PCOS diagnosis in adolescents. These guidelines also recommend a separate identification of risk group patients – adolescent patients for whom both diagnostic PCOS criteria have not yet been confirmed and who should continue to be monitored. It is important to diagnose this disease as early as possible in order to initiate lifestyle adjustments and possibly also begin treatment in a timely manner.In the long term, PCOS increases the risk of developing infertility and type 2 diabetes, cardiovascular disease, insulin resistance and metabolic syndrome. Increased body weight occurring in 40–70 % of adolescents with PCOS significantly increases the risk of chronic non-communicable diseases at a later stage, and maintains PCOS symptoms. PCOS and associated symptoms reduce health-related quality of life (HRQOL). Binge eating is more common in patients with PCOS. The most effective tactics of therapy are lifestyle changes, so it is particularly important to recognise patients at increased risk of developing PCOS, to diagnose them early and to offer treatment that is most relevant to the needs of the individual and improves their quality of life.The aim of the doctoral thesis is to explore intergenerational, genetic, quality of life and binge eating aspects in teenagers with PCOS.The study contains several sections. To evaluate the intergenerational bond, 57 teenagers with PCOS and their mothers were included in Section I. The section studies the relationship between patients with PCOS and their mothers. In addition to PCOS patients, Section II also includes healthy adolescent patients and patients at risk. The role of the most common variation of protein-coding genes involved in the activity of the Hypothalamic-Pituitary-Ovarian axis (FSHR, ESR2, LHCGR, GNRHR) in PCOS development and in the PCOS clinical presentation was studied by including 63 adolescents with a diagnosis of PCOS, 67 healthy control patients and 22 patients at risk. The role of CYP21A2 gene variations in PCOS development and clinical phenotype was established in 55 PCOS patients, 49 control patients and 23 patients at risk. Additionally, components of HRQOL, binge eating and factors affecting the total HRQOL were analysed in 63 PCOS patients and 66 control patients. The study concluded that it was not possible to predict clinical symptoms associated with PCOS in adolescents based on PCOS symptoms in their mothers. The role of protein-coding gene variations that are involved in the functioning of sex hormones was also not found, in regard to PCOS development. However, it was found that the homozygous minor allele carriers within variations of specific genes (ESR2 rs4986938 and LHCGR rs2293275) had a higher total testosterone level in blood than patients who were not carriers of these alleles. The most important components that affected HRQOL in adolescents with PCOS were the diagnosis of PCOS as such, the degree of binge eating, and the percentile of the body mass index. At the same time, HRQOL was most affected by concerns about body hair and body weight. There was no difference in the frequency of binge eating between PCOS patients and adolescent control group patients.In this study, no link was found between the diagnosis of PCOS or associated symptoms in mothers and the phenotype of adolescents with PCOS. Individual alleles have been associated with the clinical presentation of PCOS. There is a better understanding of the components of HRQOL that affect PCOS the most and require particular attention in clinical practice. Further research with a larger sample-size is needed. Furthermore, longitudinal data on the population studied in this project would provide a more accurate insight into the development of the disease at a later age.

The female reproductive system relies on the intact uterine adnexa and the hypothalamic-pituitary-ovarian axis. An imbalance can lead to pathogenesis. PCOS is characterized by ovarian cysts, hyperandrogenism, and irregular ovulation. Over time, it can lead to symptoms such as changes in menstruation, obesity, infertility, depression, and increased risk of diabetes, cardiovascular disease, and endometrial cancer. In Ayurveda, PCOS is a condition affecting Rasa, Rakta, and Medas, the three Dhatus. Rakta, Rasa, and Artavavaha are the Srotas that are implicated in this illness. Symptoms that may appear include Anartava (amenorrhea), Vandhyatwa, Pushpagni, and Abeeja Rutuchakra (an ovular hemorrhage). A 23-year-old woman presented at the outpatient department with complaints of irregular menstruation and rapid weight gain. An ultrasound revealed left-sided polycystic ovary syndrome (PCOS). Palliative treatments such as Kaklarakshak Yog, Trikatu, and Triphala Churna were administered for 2 months. The patient experienced a significant reduction in symptoms and a return to a normal menstrual cycle within two months.

This review updates the knowledge regarding the association between the polycystic ovary syndrome (PCOS) and the risk of gynecological cancer. We performed a literature review of clinical and epidemiological studies concerning PCOS and the risk of breast, endometrial and ovarian cancer after selecting information by quality of scientific methodology. It was found that evidence does not support a link between PCOS and breast cancer risk. There is an increased risk of endometrial cancer, while data concerning ovarian cancer are contradictory. Regarding PCOS and its association to cervical, fallopian tube, and vulvar cancer, the quality of evidence is heterogeneous. In conclusion, women with PCOS should be screened for endometrial cancer and more research is warranted to determine in this population the true risk of developing other gynecological cancers such as breast and ovarian.

Patients with polycystic ovary syndrome (PCOS) have ovulatory dysfunction, hyperandrogenism, and fertilility problems and are at increased risk for endometrial hyperplasia and cancer. Progesterone is required for successful embryo implantation and postimplantation embryo survival. Previous studies have shown that resistance to endogenous progesterone occurs in women with PCOS and could account for poor reproductive outcome and higher risk of endometrial hyperplasia and cancer in these women. The aim of this case-control study was to investigate possible differences in gene expression between endometrium of PCOS women and that of normal fertile controls. A model of midsecretory phase endometrium in anovulatory PCOS women treated with progesterone was used to examine endometrial gene expression, independent of clomiphene citrate, an agent commonly used to induce ovulation. Secretory endometrial samples were obtained from fertile women with normal midsecretory endometrium (MSEn) and PCOS patients after induction of ovulation with either clomiphene citrate (PCOScc) or after daily progesterone injections that mimic midsecretory endometrium (PCOSp). Gene expression in endometrial biopsies from normal (MSEn) and PCOS women (PCOScc and PCOSp) was examined using real-time polymerase chain reaction and immunohistochemistry. Total RNA extraction and cDNA and cRNA generation and hybridization with high-density human genome U133 Plus 2.0 Arrays were performed. Data on gene significance were analyzed through analysis of variance using Gene Spring GX11and Ingenuity pathways analysis. Analysis of variance analysis of the 3 comparison groups yielded 5160 genes, 466 of which represented common genes that were differentially down- or upregulated in both PCOS groups compared with MSEn. In the PCOS endometrium, downregulated progesterone-regulated genes included GRB2-associated binding protein 1, claudin-4, leukemia inhibitory factor, mitogen-inducible gene 6, and S100P; cellular proliferation genes including anillin, cyclin B1, and cyclin E2 were upregulated. These findings show significant differences in gene expression between midsecretory PCOS and normal endometrium, demonstrating that progesterone resistance, independent of clomiphene citrate, may account for poor reproductive outcomes and increased risk for endometrial hyperplasia and cancer in PCOS women.

Polycystic ovary syndrome (PCOS) is associated with the metabolic syndrome (MetS). The metabolic disorders are not universal and may vary with race, age and phenotype. Our purpose was to determine the clinical and biochemical characteristics of Mediterranean PCOS women with MetS, compare them with non-MetS PCOS patients, and assess the ability of clinical data and biochemical tests to predict these abnormalities within our population. A total of 218 subjects, 196 PCOS women and 22 controls, undergo a physical examination and laboratory evaluation for a diagnosis of MetS. MetS was categorized according to NCEP ATP III guidelines. PCOS patients were analyzed separately and compared in three subgroups: three or more MetS criteria, two criteria, one or no criteria. The overall prevalence of MetS was 21.4%. Women with MetS had higher glucose (G) levels than PCOS women with two criteria (5.7 ± 1.5 vs 5 ± 0.4, p < 0.05). Both groups were comparable for all the other parameters. Waist circumference (WC), body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), bioavailable testosterone (uT), triglycerides (TG) and insulin (I) levels were significantly higher and sex hormone-binding globulin (SHBG) levels, high-density lipoprotein (HDL), HOMA and QUICKI indexes significantly lower in both groups, MetS and patients with two criteria, compared with women with one or no criteria and the control group. WC, HDL and TG were the best predictors of PCOS patients at risk for MetS. In conclusion, we recommend considering PCOS patients with two criteria of MetS as having the same risk as patients with the full syndrome. Waist circumference with HDL and triglycerides is an efficient combined test to identify PCOS women at risk for metabolic and cardiovascular diseases.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Key features such as hyperandrogenism, hyperinsulinemia, and obesity can affect bone mineral density and biochemical markers of bone turnover. Vitamin D is linked to reproductive health, metabolic changes, and mental well-being in PCOS patients.Objectives: To assess the relationship between vitamin D, CTX (C-Telopeptide of type 1 collagen), and testosterone levels in women with PCOS.Patients and methods: This comparative cross-sectional study included 78 women with PCOS and 82 healthy controls. Serum testosterone and vitamin D levels were measured using a COBAS&reg; e411 analyzer, while CTX levels were quantified using an ELISA sandwich kit.Results: Women with PCOS had significantly higher weight, BMI, waist circumference, and waist-to-hip ratio compared to controls. Vitamin D levels were significantly lower in the PCOS group, though there was no correlation with serum testosterone or CTX levels. However, women with deficient vitamin D showed significantly higher CTX and testosterone levels compared to those with sufficient or insufficient vitamin D. Both CTX and testosterone were notably elevated in women with PCOS compared to healthy controls.Conclusions: Vitamin D levels are lower in Iraqi women with PCOS, highlighting the importance of vitamin D supplementation in their treatment. Elevated CTX levels suggest a higher risk for bone disease in PCOS patients.

Among female subjects of reproductive age, polycystic ovarian syndrome (PCOS) is a common endocrine disorder that may be linked to a number of health risks for cardiovascular diseases (CVDs). The study aims to determine some CVD risk variables and how they relate to body mass index (BMI) in female subjects with PCOS. Fifty healthy women without PCOS (controls) and 90 women with PCOS between the ages of 18 and 45 were enrolled in the study. Standard methods were used to evaluate the serum sex hormones, lipid profile, troponin-I, highly sensitive C-reactive protein (hs-CRP), fasting blood glucose, and atherogenic indices. Compared to controls, the mean age of women with PCOS was substantially lower ([Formula: see text]). The mean values of BMI, waist circumference, and hip were not significantly different from one another. While the cardiometabolic variables were higher in women with PCOS than in healthy subjects, no significant difference between obese/overweight and nonobese women with PCOS in terms of mean BMI, fasting blood glucose, insulin, atherogenic index of plasma (AIP), troponin-I, hs-CRP, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol were observed. In PCOS-affected women, AIP ([Formula: see text], [Formula: see text]), lipid accumulation product (LAP) ([Formula: see text], [Formula: see text]), and hs-CRP ([Formula: see text], [Formula: see text]) all showed positive correlations with BMI. Regardless of BMI status, there was an independent correlation between cardiovascular risk factors (CVRFs) and PCOS. This implies that regardless of a woman’s BMI, PCOS may increase her risk of CVD. Treatment combined with lifestyle modifications may be useful in lowering the risk of CVD in PCOS-afflicted Nigerian women. The finding suggests that PCOS itself, independent of weight, may increase the risk of heart disease. Nigerian women with PCOS are at increased risk of CVD, regardless of their BMI, and early detection, prevention, and treatment of CVRFs in women with PCOS is desirable.

Periodontal disease in polycystic ovary syndrome

Polycystic ovarian syndrome (PCOS) is associated with cardiovascular disease (CVD) risk factors, such as impaired glucose metabolism dyslipidaemia and arterial hypertension, predisposing to CVD in post-reproductive life. Despite the clustering of these risk factors, an association between PCOS and CVD has not been established in postmenopausal women. Relevant studies are characterized by methodological factors, such as heterogeneity in both PCOS and CVD definitions in postmenopausal women, study design, small sample size, amelioration of menstruation with ageing, and insufficient follow-up duration. Well-designed, high-quality prospective studies are needed to establish or exclude an effect of PCOS on type 2 diabetes mellitus (T2DM) and CVD risk in postmenopausal women, irrespective of obesity, ageing or menopause per se. Finally, PCOS may be associated with an increased risk of endometrial cancer; such an association has not been shown with other types of gynaecological cancer, such as breast or ovarian cancer.