Many scientists and doctors now think PCOS actually is a
diabetes precursor.
An emerging body of
research has linked a common but misunderstood gynecological disorder among
women with one of the most rapidly growing illnesses in the United States --
diabetes.
Polycystic ovarian
syndrome, or PCOS, affects up to 10 percent of American women of childbearing
age. It occurs when the ovaries manufacture too much testosterone, the so-called
male hormone, rendering them unable to produce eggs.
Dr. Geoffrey Redmond,
an endocrinologist specializing in women's health, said "There's no question
about the association."
"One of the problems
is that people haven't put the pieces together," Redmond said. "If you have PCOS
you probably have subtle insulin resistance," the key characteristic of
diabetes. "The focus has been on infertility and menstrual changes" with regards
to PCOS, he explained, "but now health care professionals need to recognize
anybody who has clear-cut signs needs to be screened for diabetes."
Although PCOS
typically is perceived as a gynecological disorder -- because it impairs
fertility and can cause irregular periods or no periods at all -- a growing body
of evidence suggests PCOS is more of a disorder of the endocrine system with
gynecological consequences.
The ovaries are part
of the endocrine system, which regulates the body's hormones, including the
hormones that govern menstruation as well as production of insulin -- another
hormone critical to metabolism.
Redmond said PCOS
appears to be genetic, particularly among women with family histories of
diabetes. Although dietary restrictions, such as cutting down on carbohydrates,
and exercise can influence the body's hormone levels and even improve insulin
sensitivity, PCOS is not curable. However, it can be easily managed with oral
contraceptives or other hormone-based medications.
For example, estimates
from Northwestern University in Evanston, Ill. -- which last November received a
$5 million grant from the National Institutes of Health to study PCOS and
diabetes -- indicate PCOS patients face a risk of diabetes seven times higher
than women who do not have the condition. Diabetes can lead to heart disease and
kidney and eye problems.
PCOS symptoms include
acne, obesity and growth of facial hair, though scientists have said women
without these symptoms still can have the condition. Irregular periods also are
a PCOS trait, though women's health experts caution that not every woman with an
irregular period has PCOS.
One medication
receiving attention among those studying PCOS is Metformin, an anti-diabetic
drug. For example, at the Pennsylvania State Hershey Medical Center, researchers
are comparing whether Metformin can help PCOS patients become pregnant by
helping to treat their hormone imbalances.
The research will
compare the women with other PCOS patients who either are taking just Clomid, an
ovulation inducer that does not treat endocrine disorders, a combination of
Metformin and Clomid, or a placebo. Results will not be available for several
months.
The research has found
40 percent of obese women with PCOS have impaired glucose tolerance, a marker
signaling diabetes, and these women have the full onset of diabetes by age 40.
Although obesity can
affect hormone balances, thin women with PCOS are just as likely to develop
diabetes because of their bodies' inability to process hormones properly, which
can lead to insulin resistance, That's something that's found in lean women
(with PCOS) as well as overweight women.
Source: Diabetes In Control Dot Com.
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