Polycystic ovary syndrome: A brain disorder characterized by eating problems originating during puberty and adolescence

Steegers-Theunissen, R�gine P. M.; Wiegel, Rosalieke E.; Jansen, Pauline W.; Laven, Joop S. E.; Sinclair, Kevin D.

Abstract

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic–pituitary–gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-Müllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.

• Journal Article Type: Article
• Acceptance Date: Oct 28, 2020
• Online Publication Date: Nov 3, 2020
• Publication Date: Nov 1, 2020
• Deposit Date: Nov 10, 2020
• Publicly Available Date: Nov 11, 2020
• Journal: International Journal of Molecular Sciences
• Print ISSN: 1661-6596
• Electronic ISSN: 1422-0067
• Publisher: MDPI
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 21
• Article Number: 8211
• DOI: https://doi.org/10.3390/ijms21218211
• Keywords: Physical and Theoretical Chemistry; Inorganic Chemistry; Organic Chemistry; Spectroscopy; Molecular Biology; Catalysis; General Medicine; Computer Science Applications
• Public URL: https://nottingham-repository.worktribe.com/output/5021629
• Publisher URL: https://www.mdpi.com/1422-0067/21/21/8211