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Polycystic Ovary Syndrome: Phenotype and Treatment

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (31 December 2019) | Viewed by 30963

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Special Issue Editors

Dr. Anju Joham

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Guest Editor

NHMRC Early Career Fellow, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia
Interests: polycystic ovary syndrome; obesity; diabetes

Dr. Soulmaz Shorakae

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Guest Editor

Postdoctoral Research Fellow, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia
Interests: polycystic ovary syndrome; obesity; diabetes

Special Issue Information

Dear Colleagues,

Polycystic ovary syndrome (PCOS) is a complex condition affecting 8–13% of reproductive-aged women. It is a common, under-recognized and increasingly prevalent condition, with serious health impacts for affected women and their families. The prevalence of PCOS varies depending on the population studied and the diagnostic criteria applied and there are limited studies in Indigenous populations. Whilst reproductive features are prominent, PCOS also has major metabolic (obesity, metabolic syndrome, gestational diabetes (GDM) type 2 diabetes (T2DM), cardiovascular risk factors (CVRFs)) and mental health consequences including poor quality of life. Whilst lifestyle factors affect the phenotypic expression of PCOS, genetic studies have shown that there are clear genetic factors contributing to the pre-disposition of PCOS. The diagnosis of PCOS is now recommended using the 2003 Rotterdam criteria, however with modern ultrasound technology, the criteria for polycystic ovary morphology on ultrasound has been recently revised. Hyperandrogenism in PCOS is a hallmark of PCOS in the majority of affected women. Psychological features are often under appreciated features of PCOS. The overall diagnosis and management of women with PCOS is often challenging as it is a complex condition with varying phenotypic expression.

Dr. Anju Joham
Dr. Soulmaz Shorakae
Guest Editors

Manuscript Submission Information

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Keywords

Polycystic ovary syndrome
Obesity
Hyperandrogenism
Depression
Polycystic ovary morphology

Published Papers (4 papers)

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Research

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12 pages, 263 KiB

Open AccessArticle

The Association between Dietary Intake, Asthma, and PCOS in Women from the Australian Longitudinal Study on Women’s Health

by Jessica A Grieger, Allison Hodge, Gita Mishra, Anju E Joham and Lisa J Moran

J. Clin. Med. 2020, 9(1), 233; https://doi.org/10.3390/jcm9010233 - 15 Jan 2020

Cited by 8 | Viewed by 3384

Abstract

Dietary intake potentially modifies the prevalence or severity of asthma. The prevalence of asthma is higher in women with polycystic ovary syndrome (PCOS); it is not known if diet confounds or modifies the association between asthma and PCOS. The aims of this study were: (i) To determine if the association of PCOS and asthma is independent of dietary pattern and (ii) to determine if dietary pattern modifies the association between PCOS and asthma. Women in this study were from the Australian Longitudinal Study on Women’s Health (ALSWH) cohort born between 1973 to 1978 and aged 18 to 23 years (n = 7382). Logistic regression was used to assess the association between PCOS and asthma, adjusting for the following: (i) Potential confounders identified a priori and (ii) dietary patterns (z-score) identified by principle component analysis. In the adjusted analysis, women with PCOS were more likely to have asthma than the women without PCOS (OR 1.35 and 95% CI, 1.02 and 1.78). This relationship was not altered by further adjustment for dietary patterns (non-core food, meats and takeaway, or Mediterranean-style pattern). In the interaction analysis, only the women consuming less than the median intake of non-core foods (i.e., lower intake of discretionary or unhealthy foods) and with PCOS were more likely to have asthma (OR 1.91 and 95% CI, 1.29 and 2.82). Dietary intake did not confound the relationship between PCOS and asthma. Other mechanistic pathways are likely responsible for the asthma and PCOS association, and further studies assessing factors such as oral contraceptive use and sex steroid hormones warrant investigation. Full article

(This article belongs to the Special Issue Polycystic Ovary Syndrome: Phenotype and Treatment)

14 pages, 542 KiB

Open AccessArticle

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort

by Chau Thien Tay, Helena J. Teede, Jacqueline A. Boyle, Jayashri Kulkarni, Deborah Loxton and Anju E. Joham

J. Clin. Med. 2019, 8(12), 2070; https://doi.org/10.3390/jcm8122070 - 25 Nov 2019

Cited by 15 | Viewed by 3888

Abstract

Women with polycystic ovary syndrome (PCOS) have many risk factors associated with perinatal mental disorders, but research in this area is scarce. This study aims to compare the prevalence of common perinatal mental disorders in women with and without PCOS, and examine the relationship between PCOS and common perinatal mental disorders. We performed a cross-sectional study on self-reported data of 5239 women born between 1973 to 1978 in the Australian Longitudinal Study on Women’s Health. Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of antenatal depression (8.9% vs. 4.4%, p < 0.001), antenatal anxiety (11.7% vs. 5.6%, p < 0.001), postnatal depression (26.8% vs. 18.6%, p < 0.001) and postnatal anxiety (18.4% vs. 12.0%, p < 0.001). PCOS was positively associated with antenatal depression and/or anxiety (adjusted odds ratio 1.8, 95% confidence interval 1.2–2.6) but not postnatal depression and/or anxiety after controlling for sociodemographic and lifestyle factors, reproductive history, obstetric complications and pre-existing depression and anxiety. General perinatal guidelines currently do not recognize PCOS as a risk factor and the international evidence based PCOS guideline noted inadequate evidence in this area. This paper addresses the gap in literature and highlights the need to screen for common perinatal mental disorders in women with PCOS. Full article

(This article belongs to the Special Issue Polycystic Ovary Syndrome: Phenotype and Treatment)

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13 pages, 290 KiB

Open AccessArticle

Disordered Eating Behaviours and Eating Disorders in Women in Australia with and Without Polycystic Ovary Syndrome: A Cross-Sectional Study

by Stephanie Pirotta, Mary Barillaro, Leah Brennan, Angela Grassi, Yvonne M. Jeanes, Anju E. Joham, Jayashri Kulkarni, Lynn Monahan Couch, Siew S. Lim and Lisa J. Moran

J. Clin. Med. 2019, 8(10), 1682; https://doi.org/10.3390/jcm8101682 - 14 Oct 2019

Cited by 27 | Viewed by 7870

Abstract

Psychological co-morbidities common in polycystic ovary syndrome (PCOS) may contribute to disordered eating and subsequent weight gain. This cross-sectional study aimed to determine the prevalence of disordered eating and a range of eating disorders and demographic risk factors associated with these behaviours within an Australian group of women with and without PCOS. Data from 899 women with (n = 501) and without (n = 398) PCOS were analysed as possibly indicative of disordered eating or eating disorders using the Eating Disorder Examination Questionnaire (EDE-Q) and The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. Disordered eating (p = 0.012) but not eating disorders (p = 0.076) were more prevalent in women with PCOS compared to controls. Increased body mass index (BMI) [Odds Ratio (OR): 1.03; 95%; Confidence Interval (CI): 1.01, 1.05, p = 0.012] and older age [OR: 1.05; 95%CI: 1.02, 1.08, p = 0.002] but not PCOS diagnosis [OR: 1.43; 95%CI: 0.96, 2.13 p = 0.078] increased the odds of disordered eating. Increased BMI [OR: 1.04; 95%CI: 1.02, 1.06, p < 0.001] and younger age [OR: -0.95; 95%CI: 0.93–0.95, p < 0.001] but not PCOS diagnosis [OR: 1.38; 95%CI: 0.97, 1.95, p = 0.076] increased the odds of an eating disorder. Clinicians are recommended to screen all women with PCOS for possible disordered eating behaviours, with particular attention to women with elevated BMI. Full article

(This article belongs to the Special Issue Polycystic Ovary Syndrome: Phenotype and Treatment)

Review

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17 pages, 1253 KiB

Open AccessReview

The Genetics of Polycystic Ovary Syndrome: An Overview of Candidate Gene Systematic Reviews and Genome-Wide Association Studies

by Danielle Hiam, Alba Moreno-Asso, Helena J. Teede, Joop S.E. Laven, Nigel K. Stepto, Lisa J. Moran and Melanie Gibson-Helm

J. Clin. Med. 2019, 8(10), 1606; https://doi.org/10.3390/jcm8101606 - 03 Oct 2019

Cited by 69 | Viewed by 15145

Abstract

Polycystic Ovary Syndrome (PCOS) is a complex condition with mechanisms likely to involve the interaction between genetics and lifestyle. Familial clustering of PCOS symptoms is well documented, providing evidence for a genetic contribution to the condition. This overview aims firstly to systematically summarise the current literature surrounding genetics and PCOS, and secondly, to assess the methodological quality of current systematic reviews and identify limitations. Four databases were searched to identify candidate gene systematic reviews, and quality was assessed with the AMSTAR tool. Genome-wide association studies (GWAS) were identified by a semi structured literature search. Of the candidate gene systematic reviews, 17 were of high to moderate quality and four were of low quality. A total of 19 gene loci have been associated with risk of PCOS in GWAS, and 11 of these have been replicated across two different ancestries. Gene loci were located in the neuroendocrine, metabolic, and reproductive pathways. Overall, the gene loci with the most robust findings were THADA, FSHR, INS-VNTR, and DENND1A, that now require validation. This overview also identified limitations of the current literature and important methodological considerations for future genetic studies. Much work remains to identify causal variants and functional relevance of genes associated with PCOS. Full article

(This article belongs to the Special Issue Polycystic Ovary Syndrome: Phenotype and Treatment)

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