Doctors have finally discovered the cause of polycystic ovarian syndrome - and they believe they’ve already found a promising treatment!
Polycystic ovarian syndrome (PCOS) is the leading cause of female infertility and impacts an estimated 10% of women of childbearing age. Despite its prevalence, doctors have struggled to identify the cause of PCOS. While the condition is diagnosed by a hormonal imbalance, the origin of this imbalance has long been a mystery. Recently, Paolo Giacobini at the French National Institute of Health and Medical Research and his colleagues have pinpointed a significant excess of a special hormone called anti-Müllerian hormone.
What Is PCOS?
PCOS presents with weight gain, excessive hair growth, failure to ovulate or menstruate, and/or cysts on the ovaries. Some women with PCOS also develop insulin resistance or pre-diabetes, a consequence of hormonal imbalance. Cysts are formed when a maturing egg implodes instead of properly maturing and being released into the fallopian tube. Many women with PCOS report pain from their cysts and several other troubling symptoms beyond the aforementioned list. Doctors diagnose PCOS with a hormone panel blood test and ovarian ultrasound. Popular theories include a genetic link that causes PCOS, since many women who have PCOS have a family history of PCOS.
How Anti-Müllerian Hormone Causes PCOS
Recently, Giacobini’s team noticed that pregnant women with PCOS had an average 30% higher level of anti-Müllerian hormone than those without PCOS. This led scientists to hypothesize that babies exposed to this hormone in utero will later develop the condition themselves. To test their theory, researchers injected pregnant mice with a large dose of anti-Müllerian hormone. The resulting baby mice showed characteristic symptoms of PCOS as they matured; later puberty, infertility, fewer offspring for those who could conceive. Anti-Müllerian hormone triggers the brain to release testosterone, which sets off a domino effect of hormonal imbalance that ultimately impacts the reproductive process.
The Promising Treatment For PCOS
When the research team noticed the testosterone overproduction, they allowed it to develop into full-blown PCOS. Once the mice were in a more advanced disease state, the team focused on treating the condition. With a better understanding of the underlying cause of PCOS, doctors are able to find a more targeted treatment. Currently, doctors often prescribe Metformin, a drug used to treat Type 2 Diabetes. The drug addresses insulin resistance and creates a more balanced hormone profile. This treatment can help patients conceive and ovulate. Otherwise, patients can take hormonal contraceptive to artificially establish hormonal stability and normalcy.
The cutting edge team of scientists decided to try a different approach. By dosing the mice with cetrorelix, an IVF drug used to control female hormones, researchers were able to test the potential of the treatment. After receiving cetrorelix, the mice showed a reversal of their symptoms.
Future Hope For Those With PCOS
Doctors are now planning a clinical trial in humans to begin before the end of the year. Giacobini is hopeful: “It could be an attractive strategy to restore ovulation and eventually increase the pregnancy rate in these women.” This discovery also could explain why women with PCOS are able to get pregnant more easily in their later childbearing years. Anti-Müllerian hormone declines with age, typically a signal that fertility is decreasing. But in those with PCOS, the excess hormone actually inhibits conception. As it drops over time, it reaches a status more amenable to pregnancy. Since the condition is not linked to genetics, doctors may be able to one day address it proactively and protect fetuses from developing PCOS in the first place.
This discovery will forever change the way doctors and scientists approach and treat PCOS - and that’s a huge plus for women everywhere.
SOURCE: New Scientist