Polycystic Ovary Syndrome
Scientists Discover Cause and Possible Treatment
Polycystic ovary syndrome (PCOS) is a condition that causes a group of symptoms in women. Those symptoms include cysts in the ovaries, weight gain, problems regulating sugar, excessive hair growth in uncommon areas and hair loss that mimics male pattern baldness. It's also responsible for acne, irregular or skipped periods and high levels of male hormones.
Women with PCOS also tend to be at higher risk of other health problems including high blood pressure, high levels of bad (LDL) cholesterol and greater risk of developing endometrial cancer. It's been linked to sleep apnea and diabetes. More than 50% of women with PCOS will have diabetes or pre-diabetes (known as glucose intolerance) before they turn 40. The risk of a heart attack is four to seven times higher for women with PCOS.
It's remarkably common, with between 10 and 20% of women affected that are of child bearing age. In the United States alone it's estimated 5 million women have PCOS.
First described by Antonio Vallisneri in 1721, PCOS is the most common cause of female infertility. Although it's widespread, little research has been conducted on the problem. There are treatments, but they tend to address the symptoms, such as treating the acne, rather than provide a cure. It is also known to run in families, but researchers have been unable to find a genetic marker for the condition.
Everything changed on May 14th of 2018. Paolo Giacobini and his colleagues at the French National Institute of Health and Medical Research published a breakthrough paper. They found that PCOS can be caused during pregnancy, by too much exposure to a hormone called anti-Müllerian hormone.
It seems that mothers who had too much anti-Müllerian hormone, were passing it on to their daughters. In fact, pregnant women with PCOS were found to have 30% higher levels of anti-Müllerian hormone than normal. Rather than a genetic cause, the hormonal imbalance during pregnancy seemed to, “reprogram the fetus and induce polycystic ovary syndrome in adulthood.”
Babies who are exposed to the excess hormone, have brain cells that are overstimulated. That causes the brain cells to raise their natural levels of testosterone, and PCOS is the result.
To test their theory, pregnant mice were injected with excess anti-Müllerian hormone. As the female baby mice grew up, they showed many of the identifying characteristics of PCOS including fewer pregnancies, infrequent ovulation and delayed puberty. Researchers had given mice PCOS by just injecting their mothers with anti-müllerian hormone during pregnancy.
The connection between the hormone and pregnancy explains why women with PCOS are more likely to get pregnant when they get older. As women with PCOS age, the levels of anti-müllerian hormone they have drops. At the same time, the symptoms of PCOS decline including the problems with fertility and weight gain. It became rather obvious, anti-müllerian hormone appears to be the cause.
Once they had a cause, they began exploring a cure. Researchers decided to give those mice a drug used on women during In Vitro Fertilization (IVF) that reduces hormones. The drug is called cetrorelix (brand name Cetrotide.) After dosing the PCOS mice, they tracked the changes to see what happened.
It worked. The drug made the PCOS symptoms go away in the mice. Ovulation returned to normal and pregnancies increased. For the first time, doctors may have a potential treatment to deal with the underlying cause of PCOS, not just the symptoms.
The idea now is to test the drug in humans. Researchers are planning human trials starting in late 2018. There's just one catch. It's estimated less than 50% of women with PCOS have been properly diagnosed with the condition. You can't get treatment unless you know what you have.
A clinical diagnosis requires that you have two of the follow three things. Missed or irregular periods, elevated levels of male sex hormones and/or at least a dozen small cysts on one or both ovaries. Talk to your doctor for more information.
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