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- PCOS is linked with a 28% increased risk of COVID-19, even when accounting for other factors.
- The common hormonal condition can cause weight gain, excess body hair, infertility, and mood changes.
- PCOS is often misdiagnosed, and research in the area isn't well-funded.
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Women with the common hormonal disorder polycystic ovary syndrome (PCOS) are at increased risk of COVID-19, a study including more than 20,000 people with the condition found.
Something about PCOS itself, rather than other factors like its link to diabetes, seems to be causing the increased risk, but more research is needed.
Women with PCOS haven't been considered a high-risk population for COVID-19, but the study authors say that's a mistake – and another example of how PCOS is often overlooked in the healthcare system.
"Before the onset of the COVID-19 pandemic, women with PCOS consistently reported fragmented care, delayed diagnosis, and a perception of poor clinician understanding of their condition," Co-author Dr Michael O'Reilly, of the Royal College of Surgeons of Ireland, said in a press release.
As a result, they may fear that a higher risk of COVID-19 "will further compromise timely access to healthcare and serve to increase the sense of disenfranchisement currently experienced by many patients."
PCOS increases the risk of diabetes, heart attacks, and depression
PCOS, which affects one in 10 women of childbearing age, is often marked by excess male hormone (or androgen) levels and small follicles on the ovaries that can disrupt menstruation, hence the name.
In addition to irregular or very heavy periods, the condition can cause excess face and body hair, skin problems, mood changes, poor sleep, and weight gain. It's the top cause of female infertility, though many people with the condition can and do get pregnant.
Doctors don't know what causes PCOS, but genetics, exposure to environmental toxins, and excess insulin may play a role.
A full 50% to 70% of PCOS patients are resistant to insulin, which leads to diabetes - a condition that also raises the risk of COVID-19.
PCOS patients are also at increased risk of heart attacks, depression, and endometrial cancer.
There's no cure for PCOS, but birth control pills and lifestyle changes can help manage it.
The study found PCOS raised COVID-19 risk by 26%, even when taking into account other factors
To conduct the study, researchers from several institutions in the UK and Ireland looked at patient records of thousands of women with and without PCOS during the first half of 2020. Because the condition makes women more prone to cardiometobolic diseases like diabetes, non-alcoholic fatty liver disease, and high blood pressure - all risk factors for COVID-19 - they wanted to see if it too made women vulnerable to the virus.
The researchers found the rate of COVID-19 in PCOS patients was close to double that in people without it. When adjusting for age and location, they found the risk of COVID-19 was closer to 51% higher in women with PCOS.
Even when further accounting for COVID-19 risk factors including obesity, glucose regulation, vitamin D deficiency, and hypertension, and heart disease, the researchers found PCOS patients still had a 26% higher risk of contracting the virus. They didn't take race, ethnicity, or socioeconomic status into account.
"It's not just about the risk factors associated with PCOS, but something in PCOS is actually driving this," lead author Anuradhaa Subramanian told CNN. It will take more research to find out, but the researchers hypothesize it could have something to do with how PCOS can create low-grade inflammation in the body.
The study authors also want to learn whether PCOS seems to affect susceptibility to severe COVID-19 or boosts to risk for long-term symptoms.
Dr. Cindy Duke, an OB-GYN, fertility specialist, and virologist based in Las Vegas, told Insider the study "further explains many of the cases of young women who are disproportionately affected by COVID and even women in their 40s and 50s."
Women with PCOS have long been overlooked by the healthcare system
PCOS symptoms like having a heavy period or gaining weight can be dismissed as part of life.
One study found a third of PCOS patients saw at least three health professionals over two years before receiving the correct diagnosis. Women may see a dermatologist for hair growth or talk to their OB about irregular periods without seeing someone who puts two and two together.
There's also little research funding for the condition compared to other illnesses with similar or lower mortality rates and prevalence, like rheumatoid arthritis, tuberculosis, and lupus.
Duke, who hosts a Clubhouse event every Wednesday at 10 a.m. EST called "let's talk PCOS weekly," told Insider many patients with the condition "are frustrated."
It's not surprising then, that PCOS was overlooked as a potential risk factor for COVID-19 until now. But the authors say it's not too late for people with the condition to take precautions against COVID-19, while keeping their mental health top of mind.
"The risk of mental health problems including low self-esteem, anxiety and depression is significantly higher in women with PCOS," joint senior author Dr. Krish Nirantharakumar of the University of Birmingham's Institute of Applied Health Research said in the press release. "Advice on strict adherence to social distancing needs to be tempered by the associated risk of exacerbating these underlying problems."