PCOS Linked to Mental Health Issues?
Polycystic ovarian syndrome, or PCOS, affects one in 10 women of childbearing age. The study, conducted by researchers at Cardiff University, found that PCOS may also increase mental health issues and an increased risk of their children developing ADHD or autism spectrum disorders, and joining us via Skype to discuss these findings, is endocrinologist, Doctor Joseph Pinzone. (applauding) Welcome, Doctor Pinzone.
Welcome, Doctor Pinzone. Welcome.
Welcome back. Thank you.
So, tell us your thoughts on this study. The study itself was long needed, and the strengths of it are that is was very large. It studied 17,000 women with polycystic ovarian syndrome, and the researchers set it up in a very clever way. So they matched these women to other women who are overweight, because that is a typical, although not mandatory, feature of polycystic ovarian syndrome, as well as other women who had similar prior mental health issues, and so I think what they’ve established is a correlation to depression, anxiety and bipolar disorder in women with polycystic ovarian syndrome. There was a small absolute increase, but it seems to be there, and as you mentioned, in their children, autism spectrum disorder and attention deficit hyperactivity disorder, again, a small, but real increase. The question is why, and that, they can’t really get at with this current study, but it’s definitely information that’s important and worth knowing. I mean, you would first, I mean, the first thought is, obviously, that it is hormonal androgenic effect, but that hasn’t been proven as of yet, correct? That is correct, and as you point out, you can think of polycystic ovarian syndrome as a pre, pre-diabetes. Yeah.
So, women with PCOS, Polycystic ovarian syndrome, have normal blood sugars, but they have a resistance to insulin, which causes the ovaries to produce more male-like hormones than women would normally produce. And I like that you pointed out the fact that it’s, the studies show maybe a small increase in the ADHD as well as the autism, and the fact that, you know, this is a starting point, but in medicine, we’re always learning more and more, and we definitely need more studies. When I talk to my patients with PCOS, as an OB-GYN, the things they typically will complain of will be the infertility, the hair growth, acne and the weight issues, and, of course, that can all be associated, kind of, with some psychological things as well, like depression and anxiety.
Yes, well, right. So we always want to address those things, but I also tell people that I think about the things they may not be thinking about, like the increased risk of diabetes, or high cholesterol, or heart disease, and also, a lot of these women will have irregular periods, and when that happens, then the inside lining of the uterus can kind of grow a little more than we want it to, and that can be associated with endometrial hyperplasia or cancer, so your doctor will wanna do something to regulate your period to try to prevent that, but there definitely is an emotional aspect to what’s going on, perhaps hormonally,
Yep. And, additionally, because of the things they see.
That’s so right. Yeah, that’s so right. I mean, that being said, I mean, I think you need to get the psychiatrist on board earlier than later. And like you said, what we know for sure, is that there’s a huge association with insulin resistance and depression, and a lot of times, that’s the first presenting complaint, and so, we’re here to be happy, and when we’re not, that’s a sign that something’s going on. This was a great study, it was done properly, what it does is show a correlation and not a causation, and so, when you have these hormonal imbalances, there’s so many downstream effects, in terms of how it makes you look, how it makes you feel, and we don’t know yet know, teasing out the effect of those hormones, why it’s causing these associations. Ish, I mean, this is a personal issue for you. It does, it — I mean, you’ve seen this. It hits home, you know, I have a darling niece, and the first sign for her was that her mood started to slip, and then once she hit puberty, she got her period in the fifth grade, and they were just terrible. She would literally be in the middle of the floor crying, and then, from there, the frustrating part, as a parent, is that you just can’t fix it, and you’re not exactly sure what’s going on, and the frustrating part, for us, is we’re not 100% sure why it’s happening or what to do. You know, she made it through college, she’s brilliant, she wrote her first book, she just graduated with her master’s degree, so it doesn’t have to be pervasive, but you’ve gotta control the levels all along, and the earlier, the better, like you said, Doctor Nita. (applauding)
And there are a lot of medications that we can do to help people, depending upon what they are experiencing, so if they have the hair growth, or the acne, or the menstrual abnormalities, we can help them with that.