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Learning more about the link between polycystic ovary syndrome and mental health

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Among the fertility issues women of child bearing age face, PCOS is a very common issue. Almost every one in ten women of fertile age is affected by it. Polycystic Ovary Syndrome aka PCOS is characterized by the presence of several small follicles in one or both ovaries, increased levels of testosterone in the blood and irregular periods.

Women who suffer from PCOS also typically have high levels of androgens in their blood “ factor that is known to affect fetal development during pregnancy. There are some other serious issues faced by women suffering from this condition “ they have problems with obesity and insulin resistance, which puts them at a greater risk of developing type 2 Diabetes. At some point, they are also more prone to have mental health problems.

A hormonal mechanism that might shed some light on why women with PCOS are more likely to develop symptoms of mental ill-health, such as anxiety and depression, in adulthood has been identified by an international team of scientists led by researchers at Karolinska Institutet in Sweden.

The results of the study have been published in the journal PNAS.

Elisabet Stener-Victorin, researcher at the Department of Physiology and Pharmacology at Karolinska Institutet and the principal investigator of the study remarked that over 60 per cent of these women are diagnosed with at least one psychiatric symptom, like anxiety, depression or an eating disorder, and suicide is much more common amongst women with PCOS than amongst healthy controls.

It has also been seen that daughters of women with PCOS are more likely to develop the condition, while their sons tend to suffer from problems of obesity and insulin resistance. One theory is that it might be due to the greater in-utero exposure to male hormones (androgens) through the mother’s blood; however the biological mechanism is unclear.

For this PNAS study, the researchers exposed pregnant rats to excessive doses of testosterone to create the conditions of pregnant women with PCOS. These rats and their fetuses were then studied – the impact on the placenta and on fetal growth was monitored. Also, they monitored the offspring – of both sexes – to adulthood and their behaviour was then tested. Their study revealed that both male and female offspring exposed to testosterone in a late fetal stage are more likely to exhibit a higher degree of anxiety behaviour as adults than those born under normal circumstances.

Further experiments were carried out and it was found and established by the researchers that the testosterone exerts the greatest effect on the amygdala – a region of the brain that has a significant role to play in emotional regulation and behaviour linked to both positive and negative emotions.

Disturbances in the activity of the gene regulating the androgen receptor in the amygdale of offspring were found by the group. They also noted changes in the receptors for a type of oestrogen and in the genes that regulate serotonin and GABA, signal substances in the brain that are known for their involvement in the regulation of anxious behaviour.

Dr. Stener-Victorin added that but when the androgenic and oestrogenic receptors were blocked by two different drugs, the animals were protected against the development of the anxiety-like behaviour in adulthood. The results of the study signal towards a hitherto unknown biological mechanism that can help in understanding why the daughters and sons of women with PCOS have a tendency to have anxiety issues as adults.

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