In women who suffer from infertility, their difficulty in conceiving is sometimes a sign of underlying health issues. For instance, it will know that women who suffer from infertility have a higher rate of pregnancy complications, even if they conceived without treatment. One of the most common causes for infertility, polycystic ovarian syndrome (PCOS) is often associated with underlying metabolic problems and women with PCOS are more likely to develop medical problems such as diabetes, high blood pressure and heart disease. However, what is less clear whether this is also true in men. A recently published study suggest that men with fertility issues and sperm abnormalities may be more likely to have other seemingly unrelated medical problems.
Polycystic ovarian syndrome (PCOS) is one the most common hormone problems in women of reproductive age as well as one of the most common causes for female infertility. While infertility caused by PCOS is often amenable to treatment, women with PCOS often have more complicated pregnancies, including problems such as gestational diabetes and pre-eclampsia. One of the common threads with these issues is their association with inflammation. It turns out there may now be a link explaining why PCOS patients have more complications. A recent study shows that markers of inflammation are higher in PCOS women and become even worse when these women get pregnant. It could be that inflammation is the common link between in PCOS and a number of pregnancy complications.
A recent study from the NIH suggests that couples who have high cholesterol levels may not just be at higher risk for heart disease, they may also have a harder time getting pregnant. Couples (who were not yet considered infertile) in which both partners or even just the female partner had high cholesterol levels on average took a longer time to conceive. These findings are not so surprising since ovulation disorders such as polycystic ovarian syndrome (PCOS) are among the most common causes for infertility, and many of these patients have underlying metabolic problems that place them at risk for heart disease and diabetes. So what does this mean? It does not mean couples trying to get pregnant should rush out and go on statins to lower their cholesterol. Cholesterol is the chemical from which sex hormones such as estrogen and testosterone are made from, so these drugs could potentially be harmful to your fertility. However, healthy lifestyle changes such as moderate excercise and avoiding processed high carbohydrate foods may help both cholesterol and fertility.
Polycystic ovarian syndrome (PCOS) is one of the most common things doctors see in both reproductive medicine and OBGYN practices. Patients often come to us complaining of infertility, miscarriages or irregular cycles, and sometime other issues such as facial hair, acne or weight issues. Because of these are the problems that bring PCOS patients in the office, most patients (and most doctors as well) think of it as a gynecologic disorder. However, most experts consider most PCOS to be a metabolic disorder, a problem with how the body handles sugar and produces insulin, and that the symptoms of PCOS are the consequences of these metabolic problems. A recent article from the Wall Street Journal, discusses PCOS and interviews some of the leading researchers in the field.
The Endocrine Society has issued new guidelines for the diagnosis of Polycystic Ovarian Syndrome (PCOS). These guidelines developed by a special task force are based in part on the Rotterdam criteria and were recently published in the Journal of Clinical Endocrinology and Metabolism.
Women are diagnosed with PCOS when they have 2 out of the 3 following conditions:
- Problems with ovulation such as irregular cycles
- Excess levels of male hormone levels on bloodwork or based on symptoms such as abnormal hair growth or loss, acne
- Large numbers of ovarian follicles or “cysts” on ultrasound
Additionally, doctors will need to rule other hormonal disorders that may mimic PCOS and are advised to screen for medical diseases such as diabetes and hypertension that are more common in women with PCOS. They also issued recommendations for treatment of infertility and irregular cycles in PCOS patients.
This month is the time to recognize Polycystic Ovarian Syndrome (PCOS), the most common hormonal disorder in women of reproductive age. It is hormone imbalance that includes irregular or absent periods, and production of higher than normal levels of male hormones such as testosterone which can result in symptoms such as facial hair, acne and hair loss. It is also a metabolic problem that can cause weight gain and lead to diabetes, high blood pressure.and heart disease. Additionally, it is one of the most common causes for infertility and something most Reproductive Endocrinologists see on a daily basis. For information from Resolve or the PCOS Association, click on the links.