Polycystic ovary syndrome and aging: Health implications after menopause

Helvacı, Nafiye; Yildiz, Bülent O.

doi:10.1016/j.maturitas.2020.05.013

Cited by 29 publications

(21 citation statements)

References 65 publications

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“…Many women with PCOS already carry some risk factors for cardiovascular disease, such as obesity, insulin resistance, dyslipidemia, dysfibrinolysis, and hypertension, which may be poorly affected by COC use. However, the evidence remains controversial regarding whether there is an absolute increase in risk for MI, stroke, cardiovascular death, or coronary heart disease in women with PCOS in the long-term [58,59], including peri-and postmenopausal periods [60][61][62][63]. Likewise, the risk of stroke-related mortality seems not to increase in PCOS [64].…”

Section: Article In Pressmentioning

confidence: 99%

“…Likewise, the risk of stroke-related mortality seems not to increase in PCOS [64]. Even so, a significant amount of data on the subject has been provided from retrospective or cross-sectional studies with small sample sizes, without taking several confounding factors into account, such as COC use [58,59].…”

Section: Article In Pressmentioning

confidence: 99%

“…Although the degree of the risk is related to race, obesity and increasing age, normal-weight women with PCOS also have a higher risk of developing IGT and T2DM than age-and body mass index (BMI)-matched healthy controls. While IGT is the leading form of glucose intolerance at younger ages, patients generally start to develop diabetes throughout their peri-or postmenopausal years [58]. Based on limited data, the risk of developing diabetes in women with PCOS during later years of life appears to be related to higher BMI, abdominal obesity, and insulin resistance, but not hyperandrogenism [67,68].…”

Section: Abnormalities In Glucose Metabolism and Diabetesmentioning

confidence: 99%

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An Update on Contraception in Polycystic Ovary Syndrome

Oğuz

Yildiz

2021

Endocrinol Metab

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patients diagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.

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Section: Article In Pressmentioning

confidence: 99%

Section: Article In Pressmentioning

confidence: 99%

Section: Abnormalities In Glucose Metabolism and Diabetesmentioning

confidence: 99%

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An Update on Contraception in Polycystic Ovary Syndrome

Oğuz

Yildiz

2021

Endocrinol Metab

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“…Studies have shown that the incidences of abortions, premature births, and pregnancy complications among PCOS patients are relatively high. Therefore, it is necessary to strengthen clinical perinatal monitoring ( 2 ). Currently, conclusions on related risk factors that lead to adverse pregnancy outcomes in patients with PCOS are not completely consistent.…”

Section: Introductionmentioning

confidence: 99%

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

Cao

et al. 2021

Front. Endocrinol.

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ObjectiveTo investigate the results of in vitro fertilization among polycystic ovary syndrome (PCOS) patients using the long-acting long protocol regarding the relationship between menstrual patterns and adverse pregnancy outcomes.DesignRetrospective cohort study.SettingUniversity-affiliated reproductive medical center.BackgroundThe menstrual patterns of patients with PCOS is considered related to metabolism; however, no study has analyzed the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of IVF/ICSI in patients with PCOS with different menstrual patterns who used the long-acting long protocol.MethodsThis was a retrospective analysis in the first cycle of IVF/ICSI at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. In total, 1834 patients with PCOS were classified into the regular menstruation group (n=214), the oligomenorrhea group (n=1402), and the amenorrhea group (n=218).ResultsPCOS patients who used the long-acting long protocol of IVF/ICSI had similar clinical pregnancy rates and live birth rates despite having different menstrual patterns. The overall incidence of adverse pregnancy outcomes, including abortion, spontaneous preterm birth (sPTB), gestational diabetes(GDM), hypertensive disorder inpregnancy (HDP), and premature rupture of membranes(PROM, was significantly higher in the amenorrhea group than in the regular menstrual and oligomenorrhea groups (25.88% vs. 30.41% vs. 43.69%; P = 0.013). Additionally, the rates of GDM (2.35% vs. 6.10% vs. 13.79%; P=0.015) and macrosomia (5.26% vs. 10.94% vs. 18.39%; P=0.026) in the amenorrhea group were significantly higher than those in the other two groups. Correction for confounding factors showed that menstrual patterns are related to the occurrence of adverse pregnancy outcomes. Amenorrhea is an independent risk factor for adverse pregnancy outcome (OR [odds ratio]: 2.039, 95% CI [confidence interval]: 1.087-3.822), GDM (OR: 5.023, 95% CI: 1.083–23.289), and macrosomia (OR: 4.918, 95% CI: 1.516–15.954).ConclusionsIVF/ICSI can achieve similar pregnancy and live birth rates in PCOS patients with different menstrual patterns. However, the overall incidence of adverse pregnancy outcomes in PCOS patients with amenorrhea is higher than that in patients with regular menstruation or oligomenorrhea.

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“…However, definition of PCOS in menopausal women is problematic. A previous history of OA, infertility, and HA have been employed in order to identify the phenotype for postmenopausal women in previous studies ( 9 ). PCOS is a life-long disorder entailing several long-term health risks ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

An overview of polycystic ovary syndrome in aging women

Çelik

Köse

2021

J Turkish German Gynecol Assoc

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The manifestations of polycystic ovary syndrome (PCOS), a ubiquitous reproductive disorder, may vary significantly depending on the severity of a number of endocrine and metabolic changes. Although no diagnostic criteria are presently available for PCOS for perimenopausal and menopausal women, the condition can still be suspected in case of a previous diagnosis of the condition, a chronic history of irregular menstrual cycles and hyperandrogenism, and/or polycystic ovarian morphology during the reproductive period. PCOS is associated with long-term health risks, including obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome and cardiovascular risk factors during reproductive age, especially in patients possessing classic phenotypes. The aim of this review was to outline the available data about the impact of PCOS on long-term health risks after reproductive age in patients with PCOS. Previously, it was assumed that women with PCOS would be more prone to develop cardiometabolic diseases after reproductive age but current data suggest that in accordance with the healing in the phenotypic characteristics of PCOS, no deterioration appears to occur in cardiometabolic health in these patients. While there is substantial evidence for a greater prevalence of abnormal subclinical atherosclerotic markers among younger patients with PCOS, data for older women are insufficient. However, there is also support for an increased risk of endometrial cancer in PCOS patients. Extensive prospective cohort studies in which healthy controls as well as patients with defining PCOS phenotypes are observed and monitored from the early reproductive period into the late postmenopausal period should now be performed in order to clarify morbidities and mortality in aging women with PCOS.

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Polycystic ovary syndrome and aging: Health implications after menopause

Cited by 29 publications

References 65 publications

An Update on Contraception in Polycystic Ovary Syndrome

An Update on Contraception in Polycystic Ovary Syndrome

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

An overview of polycystic ovary syndrome in aging women

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