Diseases of the Female Reproductive System Associated with Metabolic Syndrome

This article first came out on April 19, 20,19, and was rewritten with new information.

This article points out several diseases of the female reproductive organs linked to metabolic syndrome.

Metabolic syndrome

Metabolic syndrome is satisfied if someone has three of the five criteria.

Waist circumference over 101 cm, 40 inches (Western men) or 90 cm /35 inches (Asian men), 89 cm, 35 inches (Western women), 80 cm/ 31 inches (Asian).
Blood pressure over 130/85 or undergoing treatment for hypertension.
A fasting triglyceride over 150 mg/dl or getting treatment for a high triglyceride.
A fasting High-density lipoprotein (HDL) of less than 40 mg/dl in men or less than 50mg/dl in women or getting treatment.
Fasting blood sugar over 100 mg/dl or getting treatment for Type 2 diabetes.

Polycystic Ovarian Syndrome and Infertility

Signs and symptoms of Polycystic Ovarian Syndrome (PCOS) include menstrual irregularities, infertility, hyperandrogenism (high testosterone levels), and hirsutism.

Insulin resistance in metabolic syndrome leads to high insulin levels or hyperinsulinemia. High insulin leads to other hormonal imbalances, like high testosterone levels, that can lead to anovulation and infertility.[1]

Irregular Menstruation

Studies done in Finland [2] and Korea [3] showed the association between irregular menstruation and PCOS.

Women have testosterone too. However, they are typically converted to estrogen and stay at low levels.

In PCOS, the conversion of estrogen to testosterone is inhibited; thus, the androgens increase. Moreover, elevated levels of insulin and other hormones like the insulin-like growth factor-1 (IGF-1) act with luteinizing hormone (LH) and adrenocorticotrophic hormone (ACTH) to stimulate increased androgen production.

Figure 1 below shows the relationships between hyperinsulinemia, hormonal imbalances, and PCOS.

Source: Ali AT. Polycystic ovary syndrome and metabolic syndrome. Ceska Gynekol. 2015 Aug;80(4):279-89. PMID: 26265416.

Ovulation can resume with lifestyle change

Reversing metabolic syndrome with regular exercise and a healthy diet can make ovulation possible again.

Source: Ali AT. Polycystic ovary syndrome and metabolic syndrome. Ceska Gynekol. 2015 Aug;80(4):279-89. PMID: 26265416.However, if an unhealthy lifestyle persists, then cancers of the reproductive sytem can happen.

Ovarian Cancer

Visceral or intraabdominal fat produces inflammatory cytokines. The more visceral fat, the more cytokines are produced.

The increase in pro-inflammatory cytokines in obesity contributes to the formation of ovarian cancer. Pro-inflammatory cytokines prevent cancer cell destruction by inhibiting programmed cell death or apoptosis.[4]

Cervical Cancer

The Metabolic syndrome and Cancer Project (Me-Can) was initiated in 2006 to investigate metabolic factors concerning cancer risk. Me-Can found that the higher the BMI or Body Mass Index, blood pressure, and triglycerides, the higher the cervical cancer risk by 12%, 25%, and 39%, respectively.

In women 50-70, high cholesterol, triglycerides, and blood sugar were associated with increased cervical cancer risk.[5]

Endometrial Cancer

In Figure 1 above, endometrial cancer was included. A study involving 290,000 women from Austria, Norway, and Sweden from 1974 – 2005 identified 917 endometrial carcinomas and 129 fatal cancers.

Higher blood pressure levels, blood sugar, and triglycerides are the most common in cancer cases. Having metabolic syndrome increases the risk of endometrial cancer by 37%.[6]

Cardiovascular disease and strokes

In Figure 1 above, Diabetes Mellitus Type 2 (DMT2) and cardiovascular disease (CVD) were included. Cardiovascular diseases present as heart attacks and strokes.

All components of metabolic syndrome: high blood sugar, triglycerides, hypertension, obesity, and low HDL work together to cardiovascular diseases (CVD) and many others.

Diseases Associated with the Metabolic Syndrome

A 2022 study of 1.9 million adolescents in Israel showed that obesity in the teenage years is associated with ischemic stroke before age 30.[7]

The young lady who exercises and has a healthy diet will have a normal mentrual period and lower her future risk of stroke diabetes, strokes, cancer, and heart attacks.

Don’t Get Sick!

Related:

References:

Ali AT. Polycystic ovary syndrome and metabolic syndrome. Ceska Gynekol. 2015 Aug;80(4):279-89. PMID: 26265416.
West S et al. Irregular menstruation and hyperandrogenaemia in adolescence are associated with polycystic ovary syndrome and infertility in later life: Northern Finland Birth Cohort 1986 study. Hum Reprod. 2014 Oct 10;29(10):2339-51. doi: 10.1093/humrep/deu200. Epub 2014 Aug 1. PMID: 25085801; PMCID: PMC4164150.
Lee SS, et al. Association between Metabolic Syndrome and Menstrual Irregularity in Middle-Aged Korean Women. Korean J Fam Med. 2016 Jan;37(1):31-6. doi: 10.4082/kjfm.2016.37.1.31. Epub 2016 Jan 27. PMID: 26885320; PMCID: PMC4754284.
Craig ER, et al. Metabolic risk factors and mechanisms of disease in epithelial ovarian cancer: A review. Gynecol Oncol. 2016 Dec;143(3):674-683. doi: 10.1016/j.ygyno.2016.10.005. Epub 2016 Oct 15. PMID: 27751590; PMCID: PMC5689410.
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.
Bardugo et al. Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke. 13 May 2021. Stroke. 2021;52:2043–2052