Differences in the psychological and hormonal presentation of lean and obese patients with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders found in women of reproductive age. Differences in hormonal and metabolic profiles are observed in groups of patients with normal and elevated BMI. Cause of disturbances observed in the two groups of patients with PCOS is analyzed. The aim of the study is to assess whether psychological parameters of lean and obese patients with PCOS are comparably significantly different and whether there is a correlation between these characteristics and the concentration of various hormones.

PARTICIPANTS AND PROCEDURES: The study consisted of 20 patients with diagnosed polycystic ovary syndrome and 20 healthy women of similar age. Both groups were stratified according to BMI. Specific psychological parameters and hormones were estimated in all patients.

RESULTS: In our study, we found that patients with BMI <25 represented personality traits associated with lower resistance to stress. We also observed significantly higher ACTH levels in the same group as compared to patients with BMI >25. A correlation between plasma ghrelin and the severity of anxiety experienced by test subjects was also observed.

CONCLUSION: The type of personality and emotional disorders in lean PCOS patients may lead to the activation of the hypothalamic-pituitary-adrenal (HPA) axis and disturbences in hypothalamic-pituitary-ovary (HPO) axis. The results suggest participation of primary hypothalamic dysfunction in the pathogenesis of PCOS in patients with specific fenotype. Ghrelin is a hormone that may affect the symptoms of PCOS in lean patients. Psychological therapy should be considered as a permanent element in the therapeutic plan provided to PCOS patients.