Is PCOS an Auto-immune Disease?
Poly Cystic Ovarian Syndrome is a complex hormonal health problem affecting nearly 5 million women worldwide. It mainly affects the metabolic, reproductive, and psychological well-being of the woman. With its prevalence increasing rapidly, researchers are becoming more keen and curious about the cause of this chronic health condition. However, a clear-cut definitive cause has not yet been discovered.
Similar efforts to study this disease in more detail have resulted in raising a concern that is PCOS an auto-immune disease?
Well before getting into detail, it is important to understand what exactly is an auto-immune disease?
What is an Auto-immune Disease?
Auto-immune diseases are conditions in which the body starts to react against its own organs. The body develops auto-antibodies that fight against and destroy its own parts.
Our immune system is supposed to protect the body against various harmful foreign invaders like viruses, bacteria, and fungi. Therefore, as soon as they enter our body system, they are immediately detected and get rid of by the activation of the immune system which produces antibodies against them. In the case of auto-immune diseases, the body detects its own parts as a foreign object and starts to fight to get rid of this potential threat. In other words, the body becomes its own enemy.
There are nearly 80 known auto-immune diseases. These include Rheumatoid Arthritis, spondyloarthritis, and systemic lupus erythematosus (SLE). Auto-immune diseases are chronic conditions since they last for more than a year, require continuous medication, and are ongoing diseases. The body reacts against the joints, proteins, and heart. Hence slow and continuous destruction is carried on.
Talking about PCOS being an auto-immune disease, the literature and the research available are still insufficient and a lot of work is going on in this regard. However, a few factors can be discussed as follows:
Low Progesterone levels:
Although PCOS is yet considered an endocrinal disorder and not an auto-immune one, it might be causing the stimulation of immune system activation.
Since women with PCOS do not ovulate regularly, they have low levels of progesterone. These lower-than-normal levels can trigger the activation of the immune system of the body considering low progesterone-producing ovaries a threat to the body.
Hence auto-antibodies are produced against the ovaries which attack and potentially damage them further disturbing their normal functioning.
A study conducted to detect the possibility of PCOS being an auto-immune disease concluded higher levels of anti-ovarian antibodies in women with PCOS. This demonstrates that PCOS is possibly auto-immune disease.
Inflammatory Aspects of PCOS
PCOS is an inflammatory condition causing inflammation and multiple follicles on the ovaries. This inflammation also triggers immune-hyper stimulation since it is not something normal for the body. Hence the body considers it a threat and produces Anti- nuclear antibodies.
Research has proven high levels of these ANA antibodies in patients with PCOS. This strongly suggests the association of PCOS with auto-immune reactions of the body.
PCOS and Hyperandrogenism
PCOS causes the elevation of the male hormone testosterone i.e dihyroependisterone (DHEA). Normally, the number of androgens is very small in women's bodies. However, increased levels resulting from PCOS are responsible for immune system activation and the production of autoantibodies.
PCOS and Other Auto-immune Conditions
Another point supporting the auto-immune aspect of PCOS is its correlation with other auto-immune conditions. It is even observed that women with PCOS have significantly higher amounts of other auto-antibodies including;
Thyroid peroxidase antibodies
Anti-islet cell antibodies
These antibodies are present in the case of other auto-immune conditions like graves’ disease.
Similarly, PCOS patients are at a higher risk of developing other auto-immune disorders including auto-immune thyroiditis. The estrogen-progesterone imbalance in PCOS causes excess immune system activation which can result in the development of autoimmune thyroiditis.
Type 2 diabetes is also much more prevalent in PCOS patients. The patients are very likely to develop this condition if PCOS symptoms especially weight gain is left unchecked for a long period of time.
Insulin resistance associated with PCOS can also be a contributory factor to it being an auto-immune disease. Studies have proven the correlation of high inflammatory markers with insulin resistance. Hence the inflammatory markers are a potential threat to the immune system leading to its activation. This concept also favors the association between PCOS and auto-immune conditions.
PCOS is actually an endocrinal abnormality which at this period is not considered an auto-immune condition. However, some studies have found autoantibodies in PCOS. Moreover, a strong correlation between PCOS and other auto-immune conditions like thyroiditis and diabetes has also been found. This depicts the possibility of PCOS being an auto-immune disease. Further research and data; however, are awaited in this regard. If proven, the anti-immune medications may also be incorporated into PCOS management medications.