Women With Malfunctioning Ovaries at Higher Cardiovascular Risk

      PITTSBURGH, Nov. 9 (UPI) -- Even young women, regardless of their weight, who have certain metabolic abnormalities such as polycystic ovary syndrome may be at high risk for coronary disease by mid-life, according to a new study released Thursday.

      The disorder, a poorly understood hormonal imbalance, also known as PCOS, results in higher levels of insulin and lipids -- cholesterol and triglycerides. Those with PCOS may, as a result, face premature atherosclerosis according to a University of Pittsburgh study published in the current issue of Arteriosclerosis, Thrombosis and Vascular Biology.

      "Women with PCOS are usually seen by their doctors for symptoms such as menstrual irregularities or infertility," said Evelyn Talbott, associated professor of epidemiology at the university''s Graduate School of Public Health and lead investigator of the study. "Because it appears that PCOS may cause early onset of atherosclerosis, these women may represent the largest female group at high risk for the development of early onset coronary disease."

      The syndrome may affect as many as one in every 20 women, according to Talbott. It comes in many varieties but commonly involves infertility, irregular menstruation, excessive facial and body hair, obesity, adult acne and thinning scalp hair in some cases.

      Most of the women have insulin resistance, a preliminary step toward diabetes. For years doctors thought women with PCOS were just plagued with annoying symptoms, but not terribly unhealthy. Now PCOS is regarded as a significant health issue for many women, affecting their lives throughout the childbearing years and well after menopause.

      Some studies suggest that women with PCOS are five times as likely to get diabetes as other women. Even thin women with PCOS sometimes get diabetes. They also are believed to be at increased risk for uterine cancer.

      The name comes from one nearly universal symptom: the ovaries become packed with small cysts formed by malfunctioning egg follicles when ovulation is interrupted.

      Ultrasound screening can detect the cysts, that specialists say resemble little pearls, and blood tests can determine whether a woman has high levels of the male hormone testosterone, another feature of the syndrome.

      But not all women with the syndrome are overweight, which makes it all the more difficult to diagnose. Some women discover the condition when they are undergoing fertility treatments. Tests show that their ovaries are filled with the cysts and that their insulin levels are out of whack.

      "Therefore it is important that physicians recognize these reproductive symptoms as signs of a broader, chronic disorder and treat it accordingly with early lifestyle interventions and/or medications that will reduce cardiovascular risks," said Talbott.

      Talbott''s study looked for evidence of premature carotid atherosclerosis, or a clogging of the heart arteries among women diagnosed with PCOS who were at least 30 years of age. She also looked at healthy women that did not have the syndrome. The PCOS women had notably higher cardiovascular risks including the level of plaque in their carotid arteries.

      "These results are consistent among the PCOS women studied, regardless of their weight," Talbott said.

      The women with the PCOS had elevations in other risk factors, as well, compared to controls of similar age. These factors included a higher body mass index and waist-to-hip ratio, increased LDL cholesterol, insulin and systolic blood pressure and lower HDL, the good cholesterol. Normally, risk factors such as the high LDL are more common in obese women, not in the more slender women.

      Treatment is elusive, but some doctors, according to the literature, are prescribing Glucophage typo II diabetes drugs along a high-protein, low-carbohydrate diet.

      For more information, contact the local chapter of the Polycystic Ovarian Syndrome Association toll-free at (877) 290-5040, Extension 898.

      (Reported by Kristina Rebelo Anderson in Los Angeles)

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