Is PCOS an autoimmune disease?


Good health to all! Today I want to discuss with you the topic of polycystic ovary syndrome (PCOS). Actually, despite the plenty of information on the Internet, you can find a lot of contradictory facts. In this article, I will try to explain as much as possible the connection between PCOS and autoimmune diseases.

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Is polycystic ovarian disease an autoimmune disease?
Is polycystic ovarian syndrome a genetic disease?
Are PCOS and lupus related?
 is PCOS an immunosuppressed disease?
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Polycystic ovarian syndrome (PCOS) is a hormonal disorder that often manifests as impaired tissue sensitivity to insulin, elevated male sex hormones (testosterone), and an imbalance in the estrogen/progesterone ratio (estrogens greatly elevated in relation to progesterone).


This in turn leads to a dysfunctional ovulation process and infertility in women with PCOS.

Infertility in women with PCOS occurs when the egg does not leave the ovary at the time of ovulation. In this disease, multiple cysts form on the ovaries. These cysts are filled with fluid that contains immature eggs. The cysts can be on the surface of the ovary as well as inside it. These benign neoplasms can be located separately from each other, or they can clump together to form a single body resembling a bunch of grapes. Depending on the country and race, between 2 to 26 percent of women may have the disease. However, about 70 percent of women may not be aware of the diagnosis for a long time.

Most often, the first clear symptoms of the disease appear in adolescent girls. This is due to the onset of the menstrual cycle.

However, in this case, we are rather talking about menstrual irregularities. With polycystic disease, prolonged delays in periods are observed. Parents, and especially mothers, need to pay attention to the following symptoms in their daughter:

1. her skin and hair have become very oily

2. increased acne on the face and other areas

3. a decrease in the timbre of the girl’s voice

4. sudden and significant weight gain, sometimes even obesity. It is important to note that this symptom is observed without changes in the diet, which suggests a hormonal cause of these changes.

5. Excessive male-pattern hair growth (in the sideburns, sternum, back, white line of the abdomen, inner thighs) Girls may also complain about the appearance of a mustache above the upper lip

6. Loss of hair on the head

7. Breast pain and pulling pain in the lower abdomen

Sometimes parents don’t pay enough attention to these symptoms. If you notice them, visit the doctor.

But still, the main symptom of polycystic disease is abnormalities in the menstrual cycle.

Types of menstrual cycle abnormalities

Oligomenorrhea — the interval between menstruations from 40 to 150 days;

Secondary amenorrhea— the absence of menstruation for 6 months or more;

Irregular periods;

Some symptoms of the polycystic disease have similarities with other endocrine diseases, such as ovarian tumors, hypothyroidism, hyperprolactinemia, and adrenal hyperplasia. A qualified doctor can help determine the exact cause of the symptoms.

It is believed that the main causes of ovarian malfunction in adolescence are the following factors:

Acute, regular respiratory diseases;

Chronic tonsillitis — chronic inflammation of the tonsils

Sudden climate changes (due to traveling) on a regular basis

Prolonged stress or severe mental trauma

poor ecology

But in fact, all these circumstances are only triggers that aggravate previously formed chronic disorders.

The main factor influencing the occurrence of this disease is a congenital predisposition — the presence of polycystic disease in the pregnant mother, or other factors that have caused a lasting hormonal disruption during pregnancy. These include maternal smoking and increased BMI during pregnancy

Is polycystic ovarian syndrome a genetic disease?

This disease is often passed from mother to daughter, so it can be called genetic. But it’s more correct to add an epigenetic factor to the genetic one, since the mother’s lifestyle and habits during pregnancy, mentioned above, also increase the chance of her daughter getting the disease

doctors have recently become interested in this question:

Is polycystic ovarian disease an autoimmune disease?

Although there are studies that confirm the connection, there are also studies that refute it. How can this be interpreted? Actually, there is a direct link between these diseases. But it’s not autoimmune processes that cause polycystic disease. On the contrary, polycystic ovaries dramatically increase the risk of autoimmune diseases.

It is connected with a considerable decrease of progesterone in relation to estrogen, which leads to excessive stimulation of the immune system. Progesterone is known to suppress autoimmune reactions, including rheumatoid arthritis and multiple sclerosis. This remarkable hormone also prevents embryo rejection during pregnancy by reducing the immune response of tissue cells in the pregnant woman.

A study by Janssen et al. confirmed that autoimmune thyroiditis (AIT) is three times more common in PCOS than in healthy women.

Thus, PCOS causes an autoimmune response in women due to a decrease in the hormone progesterone, which is immune-regulating and anti-inflammatory. A significant decrease in this hormone leads to an increase in autoantibodies that attack organ tissue, an increase in inflammatory molecules, and a decrease in anti-inflammatory immune molecules.

For this reason, the polycystic ovarian disease is not considered a separate autoimmune disease. It is a disorder of the ovaries that causes hormonal imbalance, which leads to a significant increase in the likelihood of autoimmune processes in a woman’s body.

This means that not all women with ovarian disease develop autoimmune disease. Much depends on the severity of the syndrome, predisposition to one or another autoimmune disease, and related factors that provoke these diseases

These factors include



Unhealthy habits



and many others.

All of these factors could be a trigger for the development of autoimmune processes. And the presence of polycystic ovary syndrome is only one of these provoking but significant factors.

Many women are also concerned about

Are PCOS and lupus related?

Lupus is a chronic autoimmune inflammatory disease that occurs as a result of the immune system attacking its own tissues and organs. Inflammation caused by lupus can affect many organs and systems, including the skin, joints, kidneys, brain, blood cells, heart, and lungs. Although lupus erythematosus can occur at any age, it most often affects women between the ages of 15 and 40.

According to the Lupus Foundation of America, about two-thirds of people with this diagnosis may experience cutaneous lupus erythematosus, which manifests as red skin rashes and sores (lesions) on the face and other parts of the body.

Cutaneous lupus erythematosus (skin form) progresses more rapidly and severely when exposed to ultraviolet (UV) light from the sun or artificial light. Therefore, people with this skin disease often avoid light and sunlight, which can lead to vitamin d deficiency.

Renal insufficiency, which can occur in these patients, can make the situation worse, as it prevents vitamin D from being converted into its active form.

This is even more dangerous for patients with the polycystic ovarian syndrome who have lupus at the same time. Because a study by scientists found a link between low vitamin d levels and insulin resistance in women with PCOS.

Vitamin D plays an important role in the progression and activity of systemic lupus erythematosus.

Also, a study by Johns Hopkins University School of Medicine, led by Dr. Michelle Petri, found that inadequate blood levels of vitamin D in patients with Red Lupus are associated with total damage and with End-Stage Renal Disease. Taking the correct dosage of vitamin D prescribed by your doctor can reduce the progression of kidney damage.

As shown in Table 2 in the study led by Saika Sharmeen polycystic ovarian disease increases the likelihood of developing systemic lupus erythematosus, but not significantly. The risk is higher in women with more severe forms of polycystic syndrome, metabolic syndrome, insulin resistance, and vitamin d deficiency.

So if you have both of these diseases, a comprehensive approach to treatment under the supervision of a doctor (including normalization of blood sugar and vitamin D levels) may help to reduce the symptoms of both diseases.

It can be concluded that PCOS and lupus are not related. However, the more severe forms of polycystic disorder slightly increase the likelihood of developing systemic lupus erythematosus.

Both diseases are associated with low blood levels of vitamin D.

Some people also wonder if PCOS is an immunosuppressed disease?

Immunodeficiency is a disease in which the function of cells of the immune system decreases in a person, as a result of which the body ceases to resist various infections.

M Forslund and colleagues in their study found that 19 percent of women with this syndrome developed type 2 diabetes with age, compared with one percent of healthy women. It is important to note that everyone in this study who developed diabetes was also obese. Lifestyle plays an important role in the development of type 2 diabetes. Suzanne E. Geerlings and Andy I.M. Hoepelman in their study showed that diabetic patients get infections more often and have more complications than control patients.

One of the reasons for this phenomenon is increased blood glucose, which makes microorganisms more virulent (in simple words, more infectious).

By the way, the overall hospital mortality from COVID-19 is much higher among patients with diabetes than in healthy people (26.3% versus 11.3%)

Thus, dear readers, we have found out that autoimmune disease is linked to PCOS. But it is not always the same. Women with this disease are much more prone to autoimmune processes in the body than healthy women.

The same goes for immunodeficiency states.

Not all PCOS women are immunocompromised. There is an increased risk of immunodeficiency in those women who have a more severe form of the syndrome and who have comorbidities (such as diabetes) and unhealthy lifestyles.

Asymptomatic form: it is characterized only by the presence of cysts in the ovaries without other symptoms

Mild form: characterized by cysts and infertility.

Classical: highly increased male hormones in the woman, along with cysts and anovulation)

Metabolic: The symptoms of the mild and classic forms are accompanied by a decrease in the sensitivity of the insulin-dependent cells to insulin (insulin resistance) and by abdominal obesity in women, with most of the fat concentrated around the waist.

Therefore PCOS has been shown to weaken the immune system of patients with more severe forms of the disease — mild, classical, and metabolic. At the same time, asymptomatic patients may not observe a significant reduction in immunity

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