 Gay
women could be at much greater risk than heterosexual females of suffering
from Polycystic Ovarian Syndrome (PCOS), the potentially
dangerous hormone imbalance linked to Insulin Resistance.
Obesity caused by the classic Insulin Resistance symptoms of high blood
glucose and insulin levels can lead to PCOS and result in infertility.
Polycystic Ovarian Syndrome may also expose sufferers to a higher likelihood
of developing Pre- and Type 2 Diabetes, as well as the cluster of increased
risks for cardiovascular disease called Metabolic Syndrome (Syndrome X).
A study presented at the 19th European Society of Human Reproduction and
Embryology conference in Madrid showed that a large majority of lesbians
seeking fertility treatment at a London clinic suffered either solely from
polycystic ovaries (ovaries with attached, fluid-filled cysts or sacs)
or from the multiple symptoms of full-blown PCOS, ranging from ovarian
cysts to external manifestations like acne and excess facial hair (1).
Dr. Rina Agrawal, deputy medical director at the London Women's Clinic,
examined 618 women who attended the clinic for fertility treatment between
November 2001 and January 2003. Of these, 254 were lesbian and 364 were
heterosexual women.
The women did not know whether they had Polycystic Ovarian Syndrome before
attending the clinic. But 15% of them had been treated previously for symptoms
relating to PCOS such as irregular periods, inability to conceive and
excessive body or facial hair.
 The
women had a pelvic ultrasound examination on the second or third day of
their menstrual cycle and blood samples were taken to measure levels of
reproductive hormones. A clinician, nurse and counselor or clinical psychologist
took details of their medical and sexual histories in three separate sessions.
The researchers found that the prevalence of polycystic ovaries was no
less than 80% in gay women, while 32% of heterosexual women had the disorder.
Full-blown Polycystic Ovarian Syndrome was discovered in 14% of the heterosexual
women and 38% of the lesbians. The average prevalence amongst all 618 women,
lesbian and heterosexual, was 52% for ovarian cysts and 24% for PCOS. This
compares with European data showing that the incidence of polycystic ovaries
in the general female population is 22% and 10-15% for full-blown PCOS, while 40%
of all women who seek fertility treatment have either polycystic ovaries
or Polycystic Ovarian Syndrome.
Dr Agrawal said the high levels of the condition among gay women meant
that "doctors should be on the lookout for its telltale signs among
their lesbian patients in order to make sure that their wider health was
not at risk."
"We observed a significantly higher prevalence of polycystic ovaries/PCOS
in lesbians compared with heterosexual women," added Dr. Agrawal. "Our
initial results are also suggestive of a significantly greater hyperandrogenism
in lesbians compared with heterosexual women."
Hyperandrogenism is caused by abnormally high concentrations of androgens
(male steroid hormones in women). Symptoms can range from excess facial
and body hair, to baldness, acne, deepening of the voice and loss of breast
tissue.
 The
blood samples revealed that hormones such as testosterone, androstenedione,
free testosterone index and luteinizing hormone (LH) were significantly
higher - and sex hormone binding globulin (SHBG) significantly lower -
in lesbian women, compared with their heterosexual counterparts.
SHBG (sex hormone binding globulin) is a protein that binds testosterone
and other sex hormones. Women with PCOS may have normal concentrations
of total testosterone, but their SHBG is lowered and therefore free testosterone
concentrations are elevated, which results in symptoms related to hyperandrogenism.
Dr. Agrawal said: "When we compared lesbian and heterosexual women
with PCOS, lesbian women had significantly higher androgens and lower SHBG
compared with heterosexual women. We found a similar result in women with
polycystic ovaries only. But in lesbian and heterosexual women with normal
ovaries, the androgens and SHBG levels were similar.
"There are several challenges and gaps in the research and healthcare
of homosexual people and this in itself calls for focus and funding of
this aspect of medicine. In the past 20 years, only 0.1% of published articles
were dedicated to the healthcare of homosexual individuals. Before 1990,
homosexual people were invisible to healthcare research.
"Our study emphasizes the importance of treating these women in a
non-judgmental and non-biased manner, so that clinicians may offer them
appropriate health advice."
Polycystic Ovarian Syndrome is the most common endocrine (hormonal) condition
among women who menstruate and may affect up to 20% of women of reproductive
age in America. The disorder is also known as Sclerocystic
Ovarian Disease, Stein-Leventhal Syndrome and Polycystic Ovarian Disease.
As an underlying
cause of pcos, Insulin Resistance prevents the efficient conversion of blood glucose or sugar into energy because the cells walls - the means of entry for the body's fuel - have been de-sensitized to insulin.
 Insulin
acts as a "key in a lock," allowing glucose to pass through the
cell wall and be converted to energy. When there is insufficient insulin
sensitivity in the cell walls, glucose "bounces" off the cell
wall, instead of passing through the insulin "doorway." Glucose
remains in the blood stream, causing elevated levels of blood sugar, which
are sent to the liver. Once there, the sugar is converted to fat and stored
via the blood steam throughout the body.
The end result can be weight gain or obesity - both linked to the onset
of PCOS. Excess insulin caused by Insulin Resistance stimulates the ovaries
to produce large amounts of the male hormone testosterone, which may prevent
ovulation each month.
The symptoms of Polycystic Ovarian Syndrome can vary widely from woman
to woman. Not all women have all the symptoms, which range from irregular
or completely absent periods to hirsutism (excessive facial or body hair),
ovarian cysts and Alopecia (male pattern hair loss). Other symptoms can
include skin tags, Acanthosis Nigricans (brown skin patches), high cholesterol
levels, exhaustion or lack of mental alertness and decreased sex drive.
Plus sleep apnea (trouble breathing during sleeping), thyroid problems
and anxiety and depression.
Doctors very often misdiagnose PCOS. This situation became of critical
concern after a University of Pittsburgh study published in 2000 found
that sufferers have a higher risk of coronary heart disease (2).
Researchers discovered an increased association between Polycystic Ovarian
Syndrome and atherosclerosis, which occurs when fatty deposits called plaque
cling to the interior walls of the arteries, leading to blockages that
can cause a heart attack or stroke.
Not only do PCOS sufferers have higher rates of plaque build-up but those
over 45 also have thicker deposits of plaque. In addition, the imbalance
of glucose and insulin levels caused in women with Polycystic Ovarian Syndrome
leads to a lowering of "good" cholesterol and an increase in
the level of triglycerides, which are fat-storing substances carried through
the blood stream to the tissues. These factors also increase the risk of
heart attacks and stroke.
PCOS and Insulin Resistance-linked obesity are
causative factors behind infertility, which the Insulite
PCOS System can help to reverse. It is specifically designed to lower
testosterone levels and reduce weight gain by reversing the symptoms
of PCOS in combination with a balanced, nutritious diet and regular
exercise. By decreasing testosterone, it's possible to reduce ovarian cysts
and help re-establish the delicate balance of your hormones, thereby enhancing
the likelihood of ovulation, without which there is no chance of becoming
pregnant.
You may be interested in some of our Frequently
Asked Questions (FAQs) on infertility.
(1) Prevalence
of polycystic ovaries and polycystic ovary syndrome in lesbian women
compared with heterosexual women. - Agrawal R, Sharma
S, Bekir J, Conway G, Bailey J, Balen AH, Prelevic G., Fertil Steril.
2004 Nov;82(5):1352-7.
(2) Evidence
for association between polycystic ovary syndrome and premature carotid
atherosclerosis in middle-aged women - Arterioscler Thromb Vasc
Biol. 2000 Nov;20(11):2414-21. PMID: 11073846.
Click
here to read about PCOS and Menopause
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