PCOS Awareness Month – New Research Findings

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In recognition of September being National PCOS Awareness Month in the U.S., the Pulse is here with an update on some recent PCOS research findings. Polycystic Ovarian Syndrome (PCOS) is the most common reproductive endocrine disease in women of reproductive age globally. More than 10 million women worldwide live with PCOS. This hormone condition affects women of all races and ethnicities and is the leading cause of female infertility. So even though your focus may be on getting pregnant or having a healthy pregnancy, learning more about PCOS’s impact on your health will ensure you live a long and healthy life as a mother.

  1. Not all women with PCOS have cysts on their ovaries.

Doctors consider several clinical features to diagnose PCOS, and ovarian cysts are only one of those diagnostic factors.

Researchers and clinicians petitioned to change this hormonal disorder’s name because the current name confuses patients. PCOS also misleads many medical providers who might miss diagnosing PCOS in women who don’t have ovarian cysts.

Confusingly, the inverse is true as well. If you have a pelvic ultrasound and your doctor tells you that they see ovarian cysts on your ovaries, this does not mean you have PCOS.

  1. About one-half of all women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.

The risk of heart attack is 4 to 7 times higher in women with PCOS than women of the same age without PCOS. In addition, women with PCOS are at greater risk of having high blood pressure.

Research shows that PCOS does not improve or go away with pregnancy. Instead, doctors and nutritionists encourage women living with PCOS to consider it as a chronic condition to be managed aggressively throughout their lifetime. Diabetes, high blood pressure, and heart attack are not inevitable if you have PCOS. Instead, paying attention to your diet, getting regular physical exercise, and taking medications if needed, can increase your chances of living a long and healthy life.

  1. The microbiome of your gut may also be important to your PCOS diagnosis and fertility.

Your microbiome is the mix of microscopic bacteria, fungus, viruses, and their genes found all over the body, but especially in your intestines. Researchers are currently studying whether the mix of bacteria in your gut can influence both the level of inflammation involved in PCOS and the insulin resistance seen in most women with PCOS.[1] Multiple studies are currently examining whether cutting-edge therapies to rebalance the microbiome could improve your chances of getting pregnant and having a healthy pregnancy.

  1. Researchers have identified a different version of PCOS called lean PCOS.

PCOS can present differently in different women as a result of different phenotypes, or the physical outward expression of genes. Only 30-60% of women with PCOS are obese.[2] Management approaches and fertility treatments may be different for women with different phenotypes. Unfortunately, women with lean PCOS may be misdiagnosed or diagnosed much later because they do not appear physically the same as the majority of women with PCOS who have larger body sizes.

  1. Supplementation with combinations of Myo-inositol and D-Chiro Inositol (DCI) have shown promise in lowering rates of gestational diabetes in pregnant women with PCOS and in enhancing egg quality.

Inositol is a carbohydrate (sugar) known to influence carbohydrate metabolism and insulin response. Studies looking at women taking myo-inositol alone or myo-inositol combined with DCI in a ratio of 40:1, report higher rates of weight loss, ovulation, and pregnancy taking the supplements.[3]

The other good news is that inositol supplements don’t cause any unpleasant side effects and can improve insulin levels and reduce intense cravings.[4]

If you have PCOS and are trying to get pregnant, it might be worth chatting with your doctor about Inositol. Remember never to start any supplements on your own without first checking with your doctor.

  1. PCOS belly is real, whether you are pregnant or not.

PCOS belly is the painful bloating caused by excess gas swelling in your belly after eating. Researchers have identified a possible culprit: a carbohydrate called raffinose. Raffinose is commonly found in foods such as Brussel sprouts, asparagus, beans, broccoli, cabbage and cauliflower. While these vegetables contain important nutrients for pregnancy, you may want to avoid them if bloating is making your already swollen pregnant belly even more uncomfortable.

Continued Research Means Better Care For You

As a result of patient advocates and awareness-raising events such as PCOS Awareness Month, women now receive better PCOS medical care. While we still don’t have all the answers about PCOS, scientists and doctors learn more every day.

New medical information about PCOS can be confusing and overwhelming, especially when you are trying to get pregnant. However, take comfort in knowing that you are not alone. PCOS impacts roughly 1 in 10 women in their childbearing years. Even though it may be harder for you to get pregnant, many women with PCOS can have healthy, successful pregnancies. Advocate for yourself, talk with your provider about what your PCOS diagnosis means for your health and fertility, and don’t be afraid to ask questions. You and your doctor should be partners in helping you live your healthiest and happiest life, even with PCOS.

[1] Giampaolino P, Foreste V, Di Filippo C, Gallo A, Mercorio A, Serafino P, Improda FP, Verrazzo P, Zara G, Buonfantino C, Borgo M, Riemma G, Angelis C, Zizolfi B, Bifulco G, Della Corte L. Microbiome and PCOS: State-of-Art and Future Aspects. Int J Mol Sci. 2021 Feb 19;22(4):2048. doi: 10.3390/ijms22042048. PMID: 33669557; PMCID: PMC7922491.

[2] Strowitzki, T. Advanced Diagnosis of Polycystic Ovarian Syndrome- new prediction models with standard parameters. ASRM Fertility and Sterility: Reflections; 2021; 115, 1: 92-93.

[3] Wojciechowska A, Osowski A, Jóźwik M, Górecki R, Rynkiewicz A, Wojtkiewicz J. Inositols’ Importance in the Improvement of the Endocrine-Metabolic Profile in PCOS. Int J Mol Sci. 2019;20(22):5787. doi:10.3390/ijms20225787

[4] Mancini M, Andreassi A, Salvioni M, Pelliccione F, Mantellassi G, Banderali G. Myoinositol and D-Chiro Inositol in Improving Insulin Resistance in Obese Male Children: Preliminary Data. Int J Endocrinol. 2016;2016:8720342. doi:10.1155/2016/8720342

Amy Harris
Amy Harris is a certified nurse-midwife with a Master's Degree in Maternal and Child Health from Harvard Chan School of Public Health. Her passions are health literacy and women's reproductive health. A recent two-year sabbatical with her family in Spain was the impetus for becoming a freelance women's health writer. An exercise nut, she is happiest outdoors and on adventures abroad.

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