Polycystic ovary syndrome is a common reproductive disorder affecting up to 10% of women. It is characterized, among other things, by irregular menstruation and increased androgen levels. Other symptoms can include excessive hair growth, acne, infertility and poor metabolism. However, women with polycystic ovary syndrome may also be more likely to have memory and thinking problems in middle age. This is shown by new research published in the online edition of Neurology®, the medical journal of the American Academy of Neurology. The study does not prove that polycystic ovary syndrome causes cognitive decline. It simply shows a connection.
How PCOS Affects Thinking Skills and Memory
While PCOS has been linked to metabolic diseases such as obesity and diabetes, which can lead to heart problems, less is known about how this condition affects brain health. The new study results suggest that women with the condition experience poorer memory and thinking skills as well as subtle changes in the brain in midlife. This could impact on many levels, including quality of life, career success and financial security.
The study involved 907 women who were between 18 and 30 years old at the start of the study. They were followed for 30 years, during which time they completed tests measuring memory, verbal skills, processing speed and attention. At the time of the examination, 66 participants had polycystic ovary syndrome. In a test measuring attention, participants saw a list of words in different colors and were asked to indicate the color of the ink instead of reading the actual word. For example, the word “blue” could be displayed in red color, so the correct answer was red. The researchers found that women with PCOS performed about 11% worse on this test than those without the disease, on average. After adjusting for age, race and education, the researchers found that women with PCOS scored worse on three of the five tests administered, particularly in the areas of memory, attention and verbal skills, than those without the disease. In years 25 and 30 of the study, brain scans were performed on a smaller group of 291 participants.
Of these, 25 had polycystic ovary syndrome. Using the scans, the researchers examined the integrity of the brain’s white matter pathways by examining the movement of water molecules in brain tissue. The researchers found that white matter integrity was lower in women with polycystic ovary syndrome, which could indicate early signs of brain aging. Further research is needed to confirm these findings and determine how this change occurs, including examining changes women can make to reduce their risk of thinking and memory problems. A limitation of the study was that the diagnosis of polycystic ovary syndrome was not made by a doctor but was based on androgen levels and self-reported symptoms, so participants may not have accurately remembered all of the information.
PCOS and Increased Risk of COVID-19
Women with PCOS are at increased risk of developing cardiometabolic diseases such as type 2 diabetes, non-alcoholic fatty liver disease and hypertension, all of which have been identified as risk factors for COVID-19. Could women with PCOS therefore have a significantly higher risk of becoming infected with COVID-19 than women without this disease?
To investigate whether the increased metabolic risk in PCOS is associated with an increased risk of COVID-19 infection, a team of researchers from the University of Birmingham conducted a population-based closed cohort study in the United Kingdom during the first wave of the pandemic between January and July 2020. Using GP medical records in the UK, 21,292 women with PCOS and 78,310 female “controls” without PCOS, matched for age and location of GP practice, were studied. The results showed that the risk of developing COVID-19 was 51% higher in women with PCOS than in women of the same age and background who did not have PCOS.
The 26% increased susceptibility to COVID-19 infection in the PCOS cohort persisted – even after adjusting for individual cardio-metabolic risk factors, which are known to occur more frequently in PCOS and are directly linked to increased susceptibility to COVID-19 including obesity, impaired glucose regulation and high blood pressure. Research published in the European Journal of Endocrinology shows that the incidence of COVID-19 in women with PCOS is almost twice as high as in women without PCOS.
However, the study does not provide any information about the risk of a severe course of the COVID-19 infection or about the risk of COVID-19-related long-term complications. Further research is required on this.