Why are Women With Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological Maze

Gnawali, Anupa; Patel, Vaidehi; Cuello-Ramírez, Alejandrina; Kaabi, Anoud S Al; Noor, Asfa; Rashid, Mohammed Yousif; Henin, Shereen; Mostafa, Jihan A

doi:10.7759/cureus.13489

Cited by 10 publications

(11 citation statements)

References 48 publications

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“…In women with PCOS, sleep disturbance and snoring, which are common symptoms of obstructive sleep apnea, have reported to have a higher prevalence [30] and exhibit a bidirectional relationship with depression [31,32], which aligned with the ndings of the present study. Whereas obesity was reported to be associated with depression among women with PCOS by recent meta-analysis studies [2,3], the present study did not reveal this correlation. Further research is needed to better understand the relationship between obesity and mental health outcomes in this population.…”

Section: Discussioncontrasting

confidence: 99%

“…A recent meta-analysis reported a high prevalence of depression and anxiety (42% and 37%, respectively) in women with PCOS [2]. Although the mechanism of association between depression and PCOS is not fully understood, alterations in the metabolic pathway including obesity and IR and disturbances in the endocrine axes among women with PCOS may be potential pathophysiologies for the emergence of depression and anxiety [3]. Negative body image resulting from clinical manifestations of hyperandrogenism such as hirsutism, acne, and alopecia, contribute to a negative effect on mood and a reduction in self-esteem [5].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Depression and Anxiety in Women with Polycystic Ovary Syndrome (PCOS) and Associated Factors: A Cross-Sectional Study

Keeratibharat,

Sophonsritsuk,

Saipanish

et al. 2023

Preprint

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Background Polycystic ovary syndrome (PCOS) is a common gynecological problem for women of reproductive age. Depression and anxiety are common conditions that occur in women with PCOS and have an impact on mental well-being. However, there is a lake of data on their prevalence and its associated factors in the Thai population. This cross-sectional study aimed to evaluate the prevalence of depression and anxiety among women with PCOS and identify the factors associated with depression and anxiety in women with PCOS, as well as their impact on mental well-being. Methods A total of 260 women aged 15 to 40 years diagnosed with PCOS based on the Rotterdam criteria were included in the study. Physical examinations were conducted, and participants completed Hospital Anxiety and Depression Scale (HADS) and Thai version WHO-Five Well-Being Index (WHO-5 Thai) questionnaires to assess depression, anxiety, and mental well-being, respectively. Results The prevalence of depression, anxiety, and poor mental well-being among women with PCOS was found to be 3.8%, 11.9%, and 16.9%, respectively. Poor mental well-being (odds ratio [OR] 26.85, 95% confidence interval [CI]: 4.4–164.0; p = < 0.001), snoring (OR 18.16, 95% CI: 2.74-120.61; p = 0.003), moderate to severe hirsutism (OR 13.05, 95% CI: 1.66-102.64; p = 0.015), and anxiety (OR 7.02, 95% CI: 1.28–38.42; p = 0.025) were identified as factors associated with depression in women with PCOS. Having children (OR 17.84, 95% CI: 4.39–72.52; p = < 0.001) and hirsutism (OR 2.75, 95% CI: 1.18–6.37; p = 0.018) were found to be relative factors for anxiety in women with PCOS. Conclusion The present study demonstrated that PCOS is linked to depression and anxiety, leading to a significant impact on mental well-being. Hirsutism was identified as a key factor associated with depression and anxiety in women with PCOS. Based on these findings, the present study suggests that screening for depression and anxiety should be conducted in women with PCOS who present with hirsutism.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of Depression and Anxiety in Women with Polycystic Ovary Syndrome (PCOS) and Associated Factors: A Cross-Sectional Study

Keeratibharat,

Sophonsritsuk,

Saipanish

et al. 2023

Preprint

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“…The recent increase in the incidence of PCOS has affected the physical and mental health of women of childbearing age. [ 29 ] RES is under consideration as a new agent for the treatment of PCOS symptoms. [ 19 ] This study is the first to assess the effect of RES on reproductive disorders in PCOS rats and to explore the underlying mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Resveratrol Improves Follicular Development of PCOS Rats by Regulating the Glycolytic Pathway

Liang

Huang

Liu

et al. 2021

Molecular Nutrition Food Res

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Scope: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder that can cause infertility; however, the underlying mechanisms remain ill-defined, and there are no available drugs or strategies for the treatment of PCOS. This study examined the therapeutic effect of resveratrol in a rat model of PCOS. Methods and Results: PCOS is induced in rats by administration of letrozole and a high fat diet to determine whether resveratrol has a protective effect. Oral administration of resveratrol significantly decreased body weight, as well as the serum levels of testosterone and follicle stimulating hormone. Resveratrol improved the estrous cycle by restoring the thickness and number of granular cells. Resveratrol increased the levels of lactate and ATP, decreased pyruvate levels, and restored the glycolytic process, upregulating LDHA, HK2, and PKM2. Resveratrol also upregulated SIRT2, thereby modulating the expression of rate-limiting enzymes of glycolysis. Conclusion: Resveratrol suppressed damage to the ovaries in PCOS rats by restoring glycolytic activity, providing potential targets for the treatment of PCOS.

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“…Recently, the increase in the incidence of PCOS has affected the physical and mental health of women of childbearing age, even as young girls ( 30 ). RES is under consideration as a new agent for the treatment of PCOS symptoms ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Resveratrol regulates insulin resistance to improve the glycolytic pathway by activating SIRT2 in PCOS granulosa cells

et al. 2023

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ScopeInsulin resistance (IR) has a close relationship with the main clinical manifestations of patients with PCOS; hence, the research and development of new drugs to treat PCOS by improving IR is a desiderate task at present. Resveratrol (RES) possesses a variety of beneficial pharmacological functions, such as antioxidation, anti-inflammatory, regulating glucose, and lipid metabolism. However, whether RES could improve IR and the underlying mechanisms remained unclear in PCOS.Methods and resultsSD rats received a high-fat diet and letrozole for 30 days to establish the PCOS model and then intervened with RES for 30 days. The results demonstrated that RES played a protective role on the IR in PCOS rats, which significantly decreased the levels of blood glucose and serum insulin, up regulated the expression of IGF1R, and down regulated the expression of IGF1. In vitro, KGN cells were treated with insulin, RES, and AGK2, respectively. We found that a high dose of insulin (4μg/mL) significantly inhibited KGN cell viability, decreased the level of lactic acid, and increased the level of pyruvate, while RES (25μM) attenuated the growth-inhibitory effect, as well as increased the level of lactic acid and decreased the level of pyruvate after high levels of insulin treatment. Simultaneously, RES up regulated the expression level of the crucial rate-limiting enzymes relating to glycolytic pathways, such as LDHA, HK2, and PKM2. Furthermore, AGK2 remarkably inhibited the expression level of SIRT2, which was similar to the same negative effects processed by insulin. Meanwhile, RES overtly repaired the glycolysis process by reversing the levels of lactic acid and pyruvate, together with up regulating the expression level of LDHA, HK2, and PKM2, after AGK2 treatment.ConclusionRES could effectively improve insulin resistance and restore the glycolysis pathway by regulating SIRT2, which may contribute to attenuating the ovarian damage of PCOS rats and provide a potential treatment for patients with PCOS.

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Why are Women With Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological Maze

Cited by 10 publications

References 48 publications

Prevalence of Depression and Anxiety in Women with Polycystic Ovary Syndrome (PCOS) and Associated Factors: A Cross-Sectional Study

Prevalence of Depression and Anxiety in Women with Polycystic Ovary Syndrome (PCOS) and Associated Factors: A Cross-Sectional Study

Resveratrol Improves Follicular Development of PCOS Rats by Regulating the Glycolytic Pathway

Resveratrol regulates insulin resistance to improve the glycolytic pathway by activating SIRT2 in PCOS granulosa cells

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