THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
On their own, PCOS and cognitive decline are both pretty serious conditions, demanding a lot of attention from researchers in their respective fields. However, new evidence has come to light that PCOS may increase the risk of developing cognitive decline. I will break it down below.
PCOS, an acronym for polycystic ovary syndrome, is a common endocrine disorder, typically characterized by irregular periods, polycystic ovaries, and signs of excess androgen levels. Despite being the most common endocrine disorder that affects women of reproductive ages, PCOS is still significantly underdiagnosed today. According to the WHO, up to 70% of women of reproductive age have this condition, with a meager 8 to 13% being actually diagnosed.
Fortunately, information campaigns on PCOS are increasing and more people are becoming sensitized to the condition. However, it is still very difficult to diagnose the condition without seeking the opinion of an expert, making it difficult for many women to overlook it. Let me explain.
The symptoms of PCOS include irregular periods, heavy periods, excess body hairs (hirsutism), weight gain, thinning hairs, loss of scalp hair, oily skin, darkening of the skin, and acne. If you are a woman, chances are that you have experienced one or more of these symptoms at least once before. So, does that mean you have PCOS? The answer is – not necessarily, and that’s what makes PCOS difficult to diagnose.
A lot of the symptoms of PCOS are common with many other conditions, plus these symptoms may not necessarily present serious health risks. When you consider both these factors, it makes sense why many women have PCOS without ever knowing it or visiting a healthcare provider for proper care and advice. And that can be dangerous. Here’s why.
Scientists have found that PCOS can lead to infertility; in fact, PCOS is one of the leading causes of infertility in women. Also, there’s a higher risk of developing metabolic syndrome, which is associated with obesity and further elevates the risk of conditions like diabetes, stroke, and cardiovascular disorders.
Another consequence of obesity is the risk of sleep apnea. Then, conditions like depression, anxiety, and mood disorder have also been linked to PCOS. All of these complications are established and can greatly worsen the quality of life of the woman. But that’s not all – and this is where we jump to the crux of the article.
A new study has examined the relationship between women with PCOS and cognitive decline. This study spanned 30 years and included 1,163 geographically diverse women, with 907 of this population finishing the study. At year 30, women with PCOS performed worse on cognitive performance tests and had lower white matter integrity at midlife.
At face value, this looks pretty bad, but the lead author of the research ensured to clarify that this data is far from conclusive. And that’s absolutely right. Not to mention that there are glaring limitations in the study, particularly the fact that what was taken to be a PCOS diagnosis was based on the participants’ recollection of their experiences and their androgen levels. You need much more than that to arrive at an actual PCOS diagnosis. What’s more, the study did not prove that PCOS causes cognitive decline or vice versa, which the lead author suggested, as well.
Nonetheless, it would be unwise to neglect the findings of the research for many reasons. For starters, there are already different mental conditions that have been shown to be associated with PCOS, especially depression and anxiety. It is not far-fetched to imagine that there’s a way PCOS affects the brain that may result in its accelerated aging and eventual cognitive decline.
Furthermore, cognitive decline is a complex condition. For as many studies that have been carried out on the subject, there is just so much we don’t know yet. Therefore, studies that show any sort of link between cognitive decline and another condition demand some sort of attention.
Therefore, while there is no conclusive evidence yet that PCOS can actually cause cognitive decline, it would be stupid to neglect the evidence on ground. This, of course, leads us to the next logical question – what can women with PCOS do with this information? Well, this is quite simple.
If you suspect you have PCOS, you should see a healthcare provider as fast as you can and try to get a proper diagnosis. For positive diagnoses, you should immediately adopt lifestyle changes that can help combat PCOS. Also, you can talk to your healthcare provider about the proper steps to take to protect your brain health and maintain its integrity as you age.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist & Board certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ & House Call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
References
- https://www.washingtonpost.com/health/2024/02/06/pcos-cognitive-health-explained/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514592/
- https://www.neurology.org/doi/10.1212/WNL.0000000000208104#:~:text=Our%20results%20suggest%20that%20women,pathways%20including%20potential%20modifiable%20factors.
