Title: Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence.
Authors: Steegers-Theunissen, Régine P M; Wiegel, Rosalieke E; Jansen, Pauline W; Laven, Joop S E; Sinclair, Kevin D
Published In Int J Mol Sci, (2020 Nov 03)
Abstract: Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-Müllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.
PubMed ID: 33153014
MeSH Terms: Adolescent; Adolescent Behavior/physiology*; Age of Onset; Brain Diseases/complications*; Brain Diseases/epidemiology; Brain Diseases/metabolism; Child; Feeding and Eating Disorders/epidemiology; Feeding and Eating Disorders/etiology*; Female; Humans; Polycystic Ovary Syndrome/epidemiology; Polycystic Ovary Syndrome/etiology*; Polycystic Ovary Syndrome/metabolism; Polycystic Ovary Syndrome/psychology; Psychology, Adolescent; Puberty/physiology*; Risk Factors