Published 1.6.2023
Writer: Meri-Maija Ollila
Image: Shutterstock
Editing: Viestintätoimisto Jokiranta Oy

 

Polycystic ovary syndrome (PCOS) can be found in up to one out of five women of reproductive age. Despite its high prevalence, the syndrome is rather poorly known, and there is a significant number of women affected by PCOS without knowing it. The syndrome is often linked with irregular menstruation, which may be treated, especially among young women, with contraceptive pills without any further examination. Thus, the syndrome may remain unnoticed or its diagnosis is delayed.

The diagnostic criteria for PCOS were originally described already in the 1990s. Since then, knowledge about the syndrome has accumulated constantly, but many aspects still remain unclear. Typical PCOS features include menstrual cycle disorders, increased male hormone (androgen) levels shown in blood tests or manifested as excess male-type hair growth (hirsutism), and polycystic ovaries detected by gynaecological ultrasonography.

 

Not only a gynaecological problem

For some time after the publication of the diagnostic criteria for PCOS, research mainly focused on related childlessness and gynaecological issues. Recently, however, it has been observed that PCOS is not only a gynaecological problem but, rather, it impacts an individual’s life in a very comprehensive manner.

PCOS is a multifactorial syndrome, in other words, its pathogenesis is influenced by many different factors. Hereditary susceptibility is one factor and PCOS is known to be a familial disease. Also, weight gain is a risk factor for the development of PCOS and worsening of symptoms. Increased male-type hair growth, for example, is more clearly found in overweight persons.

One of the most important pathogenetic mechanisms of PCOS is insulin resistance. Impaired insulin action in the body may easily lead to elevated blood sugar levels. In addition to the above features, PCOS has been associated with, for example, gestational diabetes, asthma, elevated blood pressure (hypertension), increased susceptibility to infections as well as mental health issues and declined quality of life.

 

New information about comorbidities

At the University of Oulu, internationally top-ranking research on PCOS has been conducted for years. In my own research, I have focused on examining PCOS-related metabolic diseases, such as type 2 diabetes and cardiovascular diseases. The early studies suggested that women with PCOS have an increased risk of developing type 2 diabetes, but this understanding was later questioned on the basis of the Northern Finland Birth Cohort 1966 study material. We were the first to show that the increased risk only concerns those women with PCOS who are overweight, that is, not all women with PCOS, as was assumed earlier. This finding was of significance for both the affected women and the doctors treating them. The results provided doctors with essential information in terms of the guidance and follow-up of patients.

Recently, I have focused on the complications or additional diseases associated with type 2 diabetes, including diabetic nephropathy (kidney disease), retinopathy (eye condition) and cardiovascular diseases in women with PCOS. The research topic crystallised already when I was preparing my doctoral thesis. To my surprise, I realised that there was no previous research on diabetes-related complications in women with PCOS. So, we are addressing a completely new aspect. Complications related to type 2 diabetes are very important because they have a major impact on an individual’s perceived quality of life as well as on the long-term prognosis.

Hopefully, new research evidence will enable us both to improve the treatment of women with PCOS and enhance their quality of life and perceived health. In Finland, researchers have access to comprehensive data in health-care registers in a globally unique fashion. This facilitates the research of diabetic complications among women with PCOS. As a researcher, I feel privileged because, without these register-based materials, it would be impossible to conduct studies requiring large subject populations and long-term follow-up. Register-based research calls for a great deal of resources. The funding granted by the Sakari Alhopuro Foundation and other foundations has been a necessary condition for the implementation of our research.

More information about PCOS is available on the website of the patient association Korento: https://korento.fi/

 

 

 

 

 

MD, PhD Meri-Maija Ollila is specialising in Internal Medicine and has studied PCOS for nearly 10 years in Oulu. Ollila graduated as Licenciate in Medicine in 2018 and earned her doctoral degree in Medicine in 2019. The dissertation concerned the impacts of PCOS and overweight on the metabolic and cardiovascular risk factors and diseases in women. In addition to PCOS, she has special interest in the pharmaceutical treament of obesity and treatment of cardiovascular diseases in women.