PCOS linked to poorer health, more medication use

Women with polycystic ovary syndrome were more likely to have myriad medical conditions, use medications more often and report poorer health than women who did not have the disorder, according to a population-based Finnish study.

“I have been working on PCOS for over 20 years and during this time I have seen the emerging evidence that instead of labeling PCOS as an infertility problem, we should consider PCOS as a health risk,” Terhi T. Piltonen, MD, an OB/GYN and reproductive medicine consultant and a clinical researcher at the University of Oulu in Finland, told Healio.

Piltonen and colleagues used data from the Northern Finland Birth Cohort 1966 to evaluate health risks among 246 women who reported oligomenorrhea, amenorrhea and hirsutism by age 31years and/or a PCOS diagnosis by age 46years and 1,573 women who did not have PCOS symptoms or a diagnosis by age 46 years.

Participants self-reported their diagnoses and symptoms, overall health status, medication use and use of health care services through questionnaires administered at age 46 years.

Health status

A greater proportion of women with PCOS reported hypertension (30.4% vs. 17.9%); diabetes mellitus type 2 (6.7% vs. 2.2%); depression (20.5% vs. 14%); migraine (34.2% vs. 24.7%); knee, back or shoulder osteoarthritis (26.8% vs. 18.1%); fractures (24.5% vs. 16.8%); gestational diabetes (30.2% vs. 25.1%); preeclampsia (15.5% vs. 8.7%) and endometriosis (13.4% vs. 8.4%) compared with women who did not have PCOS.

Adjustment for BMI, physical activity, education, marital status, alcohol consumption and smoking revealed that women with PCOS were significantly more likely to report hypertension (adjusted OR = 1.76; 95% CI, 1.27-2.44), any arthrosis (aOR = 1.66; 95% CI, 1.2-2.29), migraine (aOR = 1.58; 95% CI, 1.17-2.13), tendinitis (aOR = 1.81; 95% CI, 1.22-2.68) and endometriosis (aOR = 1.81; 95% CI, 1.19-2.76).

Women with PCOS were also more likely to have autoimmune diseases — such as joint pain (aOR = 1.46; 95% CI, 1.1-1.94) and joint swelling (aOR = 1.49; 95% CI, 1.05-2.11) — and recurrent upper respiratory tract infections and symptoms — such as multiple incidences of pneumonia (aOR = 1.91; 95% CI, 1.28-2.86) and being more susceptible to infections compared with other people (aOR = 2.13; 95% CI, 1.28-3.54).

Overall, women with PCOS had a greater risk for morbidity compared with their counterparts, even when adjusting for confounding factors (RR = 1.37; 95% CI, 1.17-1.6). Specifically, women with PCOS were more likely than their counterparts to have five or more comorbidities, while women without PCOS were more likely to have fewer than three comorbidities.

Medication, health care services

Overall, women with PCOS had a higher risk for medication use compared with those who did not have the disorder (RR = 1.27; 95% CI, 1.08-1.5). In particular, they more commonly used medications that were grouped as “alimentary tract and metabolism,” “dermatological,” “systemic hormonal preparations excluding sex hormones and insulin” and “nervous system,” according to the study.

Despite the higher risk for diseases, symptoms and medication use observed in women with PCOS, there were no significant differences in the number of visits to health care providers between women with and without PCOS (OR = 1.18; 95% CI, 0.998-1.393).

Piltonen said PCOS should be diagnosed early, which “means that diagnostic criteria and tools should be well-acknowledged, accepted and adopted in clinical practice.”

In addition to developing these tools, Piltonen said researchers should evaluate the impact of PCOS after menopause.