The Relationship Between Polycystic Ovarian Syndrome, Periodontal Disease, and Osteoporosis
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REVIEW
The Relationship Between Polycystic Ovarian Syndrome, Periodontal Disease, and Osteoporosis Hannah E. Young 1,2
&
Wendy E. Ward 1,2
Received: 29 June 2020 / Accepted: 27 August 2020 # Society for Reproductive Investigation 2020
Abstract Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder to affect women in their reproductive years. There has been growing concern that women with PCOS may suffer from long-term metabolic consequences due to the high degree of insulin resistance that is often present in PCOS. However, few longitudinal studies exist in this area and there is a paucity of data on whether women with PCOS are at risk of other chronic diseases as they age. Specifically, current evidence suggests that reproductive-age women with PCOS may be at increased risk for both osteoporosis and periodontal disease (PD)—both these chronic diseases can have serious implications for health and quality of life. However, few studies have addressed how risk factors for osteoporosis and PD may be altered by aging in PCOS. The PCOS phenotype of women beyond reproductive years is poorly understood, and it is not known whether the metabolic profile of older women with PCOS results in an increased risk of osteoporosis and PD. The objective of this review is to discuss the relationships between PCOS, osteoporosis, and PD, and how these relationships could be impacted during aging. The long-term goal of this review is to provide direction for future research that is needed to more clearly elucidate these relationships and eventually provide a basis for evidence-based health recommendations. Keywords Aging . Insulin resistance . Menopause . Osteoporosis . Periodontal disease . Polycystic ovary syndrome
Introduction Polycystic ovarian syndrome is the leading cause of infertility and the most common endocrine disorder to affect women in their reproductive years [1–3]. Most studies state that PCOS affects 6–10% of women worldwide [4–6], yet some predictions are as high as 14% [7, 8]. PCOS is most often diagnosed using the Rotterdam Criteria, which defines women with PCOS as those who display at least 2 of the following: oligo- or amenorrhea, clinical or biochemical hyperandrogenism, and/or polycystic ovaries as seen by ultrasound [9]. Despite the emphasis on ovarian pathophysiology, the effects of PCOS extend beyond the reproductive system. As a complex, multisystem disorder, patients often present with adverse cardiometabolic risk * Wendy E. Ward [email protected] 1
Department of Kinesiology, Faculty of Applied Health Science, Brock University, St. Catharines, ON, Canada
2
Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
factors including insulin resistance, central obesity, dyslipidemia, and hypertension in addition to reproductive symptoms [10, 11]. As such, there has been growing concern that women with PCOS may suffer from long-term metabolic abnormalities. To address the complexities of PCOS and support optimal patient care, an international evidence-based guideli
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