Jakarta, IO – A polycystic ovary syndrome (POCS) is a common endocrinal (hormonal) abnormality, affecting some 5%-20% of reproductive-aged women. “If not diagnosed and dealt with promptly, POCS may exacerbate the risk of type-2 diabetes, metabolic syndrome and endometrium (womb wall) cancer. Unfortunately, around 50% of women suffering from POCS go undiagnosed, meaning that they fail to receive proper treatment,” reported dr. Gita Pratama, Sp.OG, Subsp.FER, M.Sc,Rep., in his doctoral promotion at the University of Indonesia Faculty of Medicine Doctorate Program, Monday (17/7/2023).
He performed his POCS study at the Yasmin Clinic, affiliated with Dr. Cipto Mangunkusumo Hospital. It involved 120 reproductive age (18-35 y.o.) women diagnosed with POCS as the subjects, categorized with a body mass index of less than 25 kg/m2.
“They underwent physical, USG, and blood checks to assess multiple hormonal and metabolic parameters. They also underwent special checks to assess the polymorphism and epigenetic mechanism (DNA methylation) in their KISS1 gene, at the Human Reproduction, Infertility, and Family Planning (HRIFP) Cluster of the Indonesian Medical Education and Research Institute (IMERI),” he said.
In his “Correlation between the Levels of Kisspeptin, Neurokinin B, and Dynorphin to the LH/FSH Ratio and the Polymorphism and Methylation of the KISS1 Gene DNA in Nonobese Polycystic Ovary Syndrome Patients” dissertation, dr. Gita reported that POCS may be signaled by menstruation problems, an increase in the level of the patient’s androgen hormone and infertility. He further cited obesity is a risk factor for POCS, according to the findings of a previous study.
“Even though obesity is proven to be a risk factor, this study demonstrated that 20%-50% of women suffering from POCS are in a normal weight range (non-obese). We hypothesize that the progress of the disease will be different for obese and non-obese women. The hormone that affects women’s reproductive system the most, luteinizing hormone (LH), originates from the brain’s hypophysial gland, and is in fact found in significantly higher levels in nonobese women with POCS than obese ones. This suggests that a hormonal imbalance in the brain (neuroendocrine) might be the most important mechanism in POCS patients of normal weight,” dr. Gita said.
The most common treatment for POCS is lifestyle modification (diet and exercise). Studies show that obese POCS symptoms improved by modifying their lifestyle. However, POCS patients with a normal weight are more likely related to hormonal disorders; simply improving a lifestyle will probably not generate significant changes in symptoms.
“It is this finding that spurred us to understand the pathogenesis, or the process of disease progression, for POCS patients, especially non-obese ones. This will help us develop the best procedure in the future,” he stated.