Item #10
Polycystic
Ovarian Syndrome (PCOS) Linked to Diabetes
Many
scientists and doctors now think PCOS actually is a diabetes
precursor.
An
emerging body of research has linked a common but misunderstood
gynecological disorder among women with one of the most rapidly
growing illnesses in the United States -- diabetes.
Polycystic
ovarian syndrome, or PCOS, affects up to 10 percent of American women
of childbearing age. It occurs when the ovaries manufacture too much
testosterone, the so-called male hormone, rendering them unable to
produce eggs.
Dr.
Geoffrey Redmond, an endocrinologist specializing in women's health,
said
"There's no question about the association."
"One
of the problems is that people haven't put the pieces together,"
Redmond said. "If you have PCOS you probably have subtle insulin
resistance," the key characteristic of diabetes. "The focus
has been on infertility and menstrual changes" with regards to
PCOS, he explained, "but now health care professionals need to
recognize anybody who has clear-cut signs needs to be screened for
diabetes."
Although
PCOS typically is perceived as a gynecological disorder -- because it
impairs fertility and can cause irregular periods or no periods at all
-- a growing body of evidence suggests PCOS is more of a disorder of
the endocrine system with gynecological consequences.
The
ovaries are part of the endocrine system, which regulates the body's
hormones, including the hormones that govern menstruation as well as
production of insulin -- another hormone critical to metabolism.
Redmond
said PCOS appears to be genetic, particularly among women with family
histories of diabetes. Although dietary restrictions, such as cutting
down on carbohydrates, and exercise can influence the body's hormone
levels and even improve insulin sensitivity, PCOS is not curable.
However, it can be easily managed with oral contraceptives or other
hormone-based medications.
For
example, estimates from Northwestern University in Evanston, Ill. --
which last November received a $5 million grant from the National
Institutes of Health to study PCOS and diabetes -- indicate PCOS
patients face a risk of diabetes seven times higher than women who do
not have the condition. Diabetes can lead to heart disease and kidney
and eye problems.
PCOS
symptoms include acne, obesity and growth of facial hair, though
scientists have said women without these symptoms still can have the
condition. Irregular periods also are a PCOS trait, though women's
health experts caution that not every woman with an irregular period
has PCOS.
One
medication receiving attention among those studying PCOS is Metformin,
an anti-diabetic drug. For example, at the Pennsylvania State Hershey
Medical Center, researchers are comparing whether Metformin can help
PCOS patients become pregnant by helping to treat their hormone
imbalances.
The
research will compare the women with other PCOS patients who either
are taking just Clomid, an ovulation inducer that does not treat
endocrine disorders, a combination of Metformin and Clomid, or a
placebo. Results will not be available for several months.
The
research has found 40 percent of obese women with PCOS have impaired
glucose tolerance, a marker signaling diabetes, and these women have
the full onset of diabetes by age 40.
Although
obesity can affect hormone balances, thin women with PCOS are just as
likely to develop diabetes because of their bodies' inability to
process hormones properly, which can lead to insulin resistance,
That's something that's found in lean women (with PCOS) as well as
overweight women.
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