What Causes PCOS? Science Says We May Have Figured It Out, But There's A Catch
Up until now, a few major questions about polycystic ovarian syndrome (PCOS) have gone unanswered. For those of you who don’t know, PCOS affects a woman’s reproductive system and fertility, but as of now, there is no cure for the condition, and treatments are limited because researchers haven’t had much success in identifying what causes PCOS in the first place. But, according to new research, there could finally be a bright light at the end of what's been a very dark tunnel for women struggling with the disorder, as scientists may have made a huge breakthrough in detecting where PCOS stems from in the body, and in turn, they may be paving the way for totally new treatments of the condition moving forward.
Now, before I break down the details of this exciting discovery, let’s backtrack for a moment to talk about what we concretely know about PCOS. According to the U.S. Department of Health and Human Services' Office on Women’s Health, PCOS is a hormonal imbalance that affects one in every 10 women between the ages of 15 and 44 years old (aka prime childbearing years). Symptoms of PCOS, per the PCOS Awareness Association, can vary, depending on the individual’s body: Some women might develop cysts on their ovaries or struggle with weight gain, while others may experience fatigue, excessive hair growth or hair loss, hormonal acne, severe pelvic pain, heavy bleeding, or even trouble sleeping.
Past research has explored insulin resistance and genetics as potential causes of PCOS, but a new study suggests the condition could be related to something else entirely.
Before this new study was published, research has shown that a woman’s anti-Müllerian hormones (AMH) — which are hormones released by cells in a woman’s follicles just outside the ovaries — can interact with certain neurons in the brain. This line of communication then leads to the release of something called luteinizing hormone (LH), which encourages ovulation. Women with PCOS, though, tend to have high levels of LH, according to ScienceAlert, and that excessive amount of hormones actually prevents ovulation, spikes testosterone levels, and can lead to infertility.
So here’s how the new study, which has been published in the journal Nature Medicine, went down: First, Science reports, researchers drew blood from four groups of pregnant women during the second trimester of their pregnancies, in order to compare the AMH levels of women with and without PCOS (Science notes that AMH levels typically drop during pregnancy, "because the ovaries aren’t active"). According to their assessment, though, the pregnant women with PCOS were found to have two to three times as much AMH in their blood as the pregnant women who didn't have PCOS. From there, the scientists switched over to mouse models to determine whether or not these high AMH levels in pregnant women could affect their offspring. In order to test that theory, they injected pregnant mice with the AMH hormone, and interestingly enough, the results showed that the baby female mice did, indeed, develop symptoms of PCOS, like high testosterone levels and low ovulation. In other words, symptoms of PCOS might actually be genetic, and could potentially be passed on from mother to daughter.
Obviously, mice are not humans, so there's still some speculation over whether these findings can be applied to humans, but it's definitely something to explore further.
As of now, there isn’t one solid test that can definitively determine whether or not a woman has PCOS, which is sort of what makes this study such a big deal. According to Mayo Clinic, doctors will generally issue a series of tests like pelvic exams, blood tests, and an ultrasound, as well as a thorough study of your medical history, before issuing an official diagnosis. And if you think a diagnosis sounds tricky to nail down, just imagine how complicated it can be to find a treatment that works for your specific case, when your doctor is going off of very little knowledge of where and how PCOS even develops.
Given what most research in this area has found thus far, treatment options for PCOS often focus on a combination of lifestyle changes and medication. Your doctor might prescribe you a combination birth control pills that have both estrogen and progestin to regulate the hormones that might be causing your PCOS symptoms to persist, or they may suggest a regular workout plan to maintain a healthy weight and manage your insulin levels, or they may even come up with a diet plan that works to both reduce the insulin and balance out your hormones.
Now, all of those treatments sound pretty vague, don’t they? Personally, I don’t suffer from PCOS, but women who do have spoken up about how difficult it can be to diagnose and treat PCOS because of a lack of research to back up what causes the condition, and how that can often throw doctors for a loop when it comes to finding the right treatment for any given patient. But that’s exactly why this new research could be such a huge deal: If this potential cause of PCOS holds true in humans the same way it does in female mice, it could lead to advanced treatment options, and maybe even a cure someday. So even though experts have a long way to go before finding a definitive cure for PCOS, the wait may not be as long as we've all anticipated.