Polycystic Ovarian Syndrome (PCOS) and Infertility
The main clinical features of PCOS include menstrual irregularities, sub-fertility, hyperandrogenism (high testosterone or male hormone), and hirsutism (hairy). The report, Polycystic ovary syndrome, and metabolic syndrome explain how PCOS can cause infertility. Insulin resistance, found in metabolic syndrome, leads to a high insulin level (hyperinsulinemia, HI). HI is needed to “push” the glucose into the liver and skeletal muscle. The high testosterone level creates a hormonal imbalance and a lack of ovulation, leading to infertility. PCOS puts women at a higher risk for cardiovascular disease because of the presence of insulin resistance, hyperinsulinemia, obesity, dyslipidemia, glucose intolerance, and hypertension.
Irregular Menstruation
Studies that were done at Finland, Irregular menstruation and hyperandrogenemia in adolescence are associated with polycystic ovary syndrome and infertility in later life: Northern Finland Birth Cohort 1986 study and in Korea, Association between Metabolic Syndrome and Menstrual Irregularity in Middle-Aged Korean Women, have shown the association between irregular menstruation with Polycystic Ovarian Syndrome. Typically, the androgens in women are converted to estrogen. In PCOS, that conversion is inhibited, which results in an increase in the male hormone, androgen. The high insulin and insulin-like growth factor 1 (IGF-1) acts with the other hormones like luteinizing hormone (LH) and adrenocorticotrophic hormone (ACTH) to stimulate more androgen production. This results in both increases in circulating androgen and increased androgen production from the adrenal gland. ¹
This study, Associations Between the Periodontal Disease in Women Before Menopause and Menstrual Cycle Irregularity, examined the relationship between periodontal disease and menstrual irregularities. Periodontitis is a gum disease that leads to an early loss of teeth. It has been associated with MetS. Refer to this article, Periodontitis and Metabolic Syndrome. They conclude that menstrual irregularity is a potential risk indicator for periodontitis in the future.
Ovarian Cancer
The obesity in MetS, as measured by the waist circumference, affects ovarian cancer formation by the production of cytokines. Cytokines produced by the fat cells and promote cancer formation and prevent cancer cell destruction by the immune system. Normal cell death (apoptosis) is also blocked, and old precancerous cells contribute to a cancer formation. This review, Metabolic risk factors and mechanisms of disease in epithelial ovarian cancer, goes into the detail of how different cytokines, signal transductors, and immune system are altered by obesity that creates an environment conducive to the formation of the aggressive epithelial ovarian cancer. It is a satisfying read for the academically inclined.
Cervical Cancer
The Me-Can project is a study about the different cancers related to metabolic syndrome. The findings for cervical cancer are that the higher the BMI or Body Mass Index, blood pressure, and triglycerides, the higher cervical cancer risk by 12%, 25%, and 39%, respectively. Triglycerides were stronger associated with squamous cell carcinoma than with adenocarcinoma. In older women (50-70 years), high cholesterol, triglycerides, and glucose were associated with increased cervical cancer risk.
Endometrial Cancer
In a study involving 290,000 women from Austria, Norway, and Sweden in 1974 – 2005. A total of 917 endometrial carcinomas and 129 fatal cancers were identified. There is,
Increased risks of incident endometrial carcinoma and fatal uterine corpus cancer were seen for the metabolic syndrome factors combined, as well as for individual factors (except for cholesterol).
Prevention of Metabolic syndrome also prevents and/or mitigates many common non-infectious diseases.
A diagnosis of any disease related to the Metabolic Syndrome should prompt an investigation if you are at risk of developing ischemic heart disease. Talk to your doctor if there is a need to do a fasting blood sugar, serum triglyceride, and HDL level checked. Check your blood pressure and measure your waistline, then review the criteria for the MetS and see if you have it.
Related Readings:
- The Metabolic Syndrome
- Diseases of the Male Urinary and Reproductive System Associated with Metabolic Syndrome
- Cancers Associated with Metabolic Syndrome
Additional References:
1. Hala T. and Silva A. Menstrual Health and the Metabolic Syndrome in Adolescents. Ann N Y Acad Sci. 2008; 1135: 85–94.
Eric R. C, Angelina I, Lyse N, and Rebecca A., Metabolic risk factors and mechanisms of disease in epithelial ovarian cancer: A review. Gynecol Oncol. 2016 Dec; 143(3): 674–683.
Ulmer H, et al. Metabolic risk factors and cervical cancer in the metabolic syndrome and cancer project (Me-Can). Gynecol Oncol. 2012 May;125(2):330-5.
Bjørge T et al. Metabolic syndrome and endometrial carcinoma. Am J Epidemiol. 2010 Apr 15;171(8):892-902. doi: 10.1093/aje/kwq006. Epub 2010 Mar 10.
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Polycystic Ovary: http://www.scientificanimations.com/wiki-images/
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