Kalpana Dash
Apollo Hospitals Education and Research Foundation, India
Title: Effects of PCOS on women's health
Biography
Biography: Kalpana Dash
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females in their reproductive age with prevalence varying from 6.1–19.9% depending on the diagnostic criteria used. There is a 7-fold increase in risk of myocardial infarction (MI) in PCOS women. However, a retrospective study in the United Kingdom, demonstrated that PCOS women neither had raised mortality nor MI morbidity, despite of having higher prevalence of above metabolic risk factors and hypertension. Surprisingly, same study has demonstrated higher prevalence of stroke among this cohort of PCOS women. Two studies reported an increased risk of endometrial cancer in PCOS. Breast cancer is the most common cancer and the risk is not higher than the normal population. Mood disturbances, severe depression, and reduced quality of life are independent CVD risk factors and very common among women with PCOS. Depression and anxiety in PCOS patients, lead to fatigue, sleep disturbances, phobia, change in appetite change, and binge eating habits. Nonalcoholic fatty liver disease (NAFLD) is common (27.4–62%) compared to age and weight matched non-PCOS individuals. However the progression of NAFLD to NASH is less frequent. Prevalence of advanced liver disease (NASH with fibrosis) is very high, even in the adolescent females with PCOS. Weight loss is a part of treatment and helps in reversing the natural history of NAFLD. Obstructive sleep apnea syndrome (OSA) in women with PCOS is 5 to 30 fold higher. It is demonstrated that, IGT is 2-fold higher (55 vs. 23%) in women with PCOS with OSA compared with those without OSA. Successful treatment of OSA improves cardio-metabolic function, blood pressure, and insulin sensitivity in obese women with PCOS. In conclusion, polycystic ovary syndrome (PCOS) is the most common (6.1-19.9%) endocrinopathy in women. Common diagnostic features are hirsutism, acne, polycystic-appearing ovaries, obesity and oligo/amenorrhea. It has many features in common with the metabolic syndrome such as insulin resistance, central obesity, hypertension, IGT/ diabetes mellitus, dyslipidemia, increased prevalence of CVD and all-cause mortality. They have a higher prevalence of breast cancer, uterine cancer, infertility, NAFLD, OSA, depression, mood disturbances and decreased quality of life.