Share on PinterestNew research suggests a link between PCOS and cognitive decline in midlife. Westend61/Getty ImagesPolycystic ovarian syndrome (PCOS) is a long-term hormonal endocrine disorder that can impact various aspects of health.Previous studies have shown that individuals with PCOS are at a higher risk of developing several conditions such as type 2 diabetes, endometrial cancer, and high blood pressure. Researchers from the University of California, San Francisco have now discovered that people with PCOS may also be at an elevated risk of experiencing memory and cognitive issues in middle age. Approximately 116 million women worldwide have polycystic ovarian syndrome (PCOS), which is a chronic hormonal endocrine disorder affecting the reproductive system in individuals assigned female at birth.Common symptoms of PCOS may include irregular or absent periods, acne, enlarged ovaries, excessive body hair, and infertility. Previous research has indicated that individuals with PCOS are at an increased risk for various other conditions, including type 2 diabetes, heart disease, obstructive sleep apnea, liver disease, depression, and endometrial cancer. Now, researchers from the University of California, San Francisco have added to this list by uncovering evidence suggesting that individuals with PCOS may be more susceptible to developing memory and cognitive issues in middle age. The study was recently published in Neurology, the medical journal of the American Academy of Neurology.According to Dr. Heather G. Huddleston, a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco, and the lead author of this study, they decided to investigate the impact of PCOS on brain health due to the known differences in reproductive hormones and metabolic health associated with this disorder, particularly insulin resistance.“We also understand that hormones and metabolic health can influence brain health, especially as individuals age,” Dr. Huddleston informed Medical News Today. “Therefore, we believed it was important to examine brain health in older women with PCOS, especially since no previous studies had addressed this question.”Individuals with PCOS often have high levels of androgen hormones, such as testosterone, and low levels of progesterone. Prior research has indicated that androgens may sometimes have neurotoxic effects, while progesterone has neuroprotective effects, which may be diminished with low levels. For this study, Dr. Huddleston and her team enlisted 907 female participants who were between 18 and 30 years old at the commencement of the study, and were subsequently monitored by researchers for 30 years. At the end of the 30-year period, all participants were required to undergo tests to assess their memory, verbal learning, cognitive control, processing speed, and attention. At the time of testing, 66 study participants had been diagnosed with PCOS. The researchers found that participants with PCOS achieved lower scores on three of the five tests administered, specifically in the areas of memory, attention, and verbal abilities, compared to those without PCOS.For the test assessing attention, the scientists reported that participants with PCOS scored an average of approximately 11% lower than those without the condition. “We had a hypothesis that we might find evidence of lower cognitive scores with aging, based on what we already know about various health conditions that can affect the brain,” Dr. Huddleston commented. “However, these study participants were relatively young (mid-life), so in some ways, I was still surprised to see the differences that we did.” To further substantiate their findings, the research team carried out a smaller study involving 291 participants who underwent MRI brain scans at years 25 and 30 of the larger study. Of this smaller group, 25 had PCOS. Through the MRI scans, the scientists were able to assess the integrity of white matter pathways in the brain. White matter assists the brain in processing information and connects the areas of the brain responsible for learning, balance, focus, and problem-solving. Dr. Huddleston and her team discovered that participants with PCOS exhibited lower white matter integrity compared to those without the condition. “White matter integrity on MRI can be an early indication of changes in the brain that can occur with aging,” Dr. Huddleston clarified. “We did not find any of the more significant changes, such as abnormal white matter, so it is reassuring that only early signs were found.” “I believe it is crucial that we confirm these findings in other populations and/or datasets,” she continued. “I am also extremely interested in establishing a longitudinal study of women with PCOS to ascertain if and when differences in cognition begin to emerge. Finally, it would be fascinating to conduct a study to explore ways to protect brain health in this population.”As more information emerges linking PCOS and brain health, it may become increasingly important for healthcare professionals to discuss with individuals with PCOS how it could potentially impact their cognition. Dr. Huddleston noted that there are health practices that can safeguard brain health. “For instance, we know that exercise has significant effects on the brain and can help protect the brain from accelerated decline with aging,” she outlined. “So, initially, encouraging physical activity would be an important recommendation.”“Along these lines, managing cardiovascular risk factors, such as dyslipidemia, hypertension, and diabetes, is crucial,” Dr. Huddleston added. “These conditions are elevated in PCOS but also have a range of very effective treatments. “For these reasons, ensuring that women with PCOS have access to comprehensive and informed care is crucial. MNT also spoke with Dr. Michael Krychman, a board-certified OB/GYN and medical director of Women’s Health Services at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.Dr. Krychman stated that he was not surprised by the findings of this study. “PCOS is strongly associated with various metabolic health conditions such as obesity, diabetes, hypertension, (and) heart health issues,” he explained. “There are changes in hormones, including androgens. So the association between PCOS and cognitive decline or memory issues is not very surprising at all.”When it comes to discussing with individuals with PCOS about its potential impact on their brain health, Dr. Krychman suggested that the entire focus for PCOS should really be on a comprehensive treatment approach encompassing biological, psychological, and social aspects. “So it’s not just about hormonal balance and hair and acne, but also, I think we will now incorporate primary prevention of cognitive decline into treatment paradigms,” he continued. “And what that may look like is keeping active, limiting alcohol, maintaining a healthy diet, monitoring cardiometabolic issues, sugar control, (and) cholesterol control.”“Also, the concept of cognitive enrichment, like playing games, reading a book, memory training — all those things will help enrich your life and may help preserve mental function,” Dr. Krychman added. “The concept of focusing on brain health in a multi-dimensional factor will be really important.”
