Polycystic ovary syndrome more prevalent in overweight women

Overweight and obese Spanish women appear five times as likely as lean women to have polycystic ovary syndrome, a condition that decreases fertility and contributes to other illnesses, according to an article in the October 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Polycystic ovary syndrome occurs when the ovaries malfunction and levels of the sex hormone androgen are unusually high. Symptoms may include irregular or no menstrual periods, acne and excess hair growth. In addition to its implications for reproductive health, polycystic ovary syndrome is also associated with sleep apnea, poor quality of life and an increased risk for diabetes and cardiovascular disease, according to background information in the article.

Although more than half of patients with polycystic ovary syndrome are obese, the prevalence of the condition in overweight or obese women is unknown.

Francisco Álvarez-Blasco, M.D., and colleagues at Hospital Universitario Ramón y Cajal, Madrid, Spain, evaluated 113 consecutive women who visited one hospital for weight loss treatment between May 2002 and December 2005. The women were diagnosed with polycystic ovary syndrome based on whether their ovaries were releasing eggs regularly, tests to assess the level of androgen in their blood and whether other diagnoses could be ruled out.

Of the 113 women, 32 (28.3 percent) were diagnosed with polycystic ovary syndrome, compared with the established rates of 6.5 percent among all women and 5.5 percent among lean women. "The prevalence of polycystic ovary syndrome was not statistically different when considering the degree of obesity, as classified according to the guidelines published by the National Institutes of Health," the authors write. Patients with the syndrome tended to be younger and were more likely to also have insulin resistance, which occurs when the body has difficulty using the insulin it produces to turn glucose into energy.

"In summary, we report that the prevalence of polycystic ovary syndrome is markedly increased in unselected overweight and obese women seeking medical advice for weight loss, independent of the degree of obesity or the presence or absence of the metabolic syndrome and related disorders," the authors continue. "We conclude that physicians treating overweight and obese patients should be aware of the high prevalence of polycystic ovary syndrome among these women and that screening for polycystic ovary syndrome, at least by obtaining a detailed menstrual history and a careful clinical evaluation of hyperandrogenic symptoms, should be conducted routinely to diagnose polycystic ovary syndrome and ameliorate the health burden distinctly associated with this prevalent disorder."

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(Arch Intern Med. 2006;166:2081-2086. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by grants from the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.


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