Study details and key findings

PCOS is a common reproductive disorder related to hormonal imbalances in women. Some symptoms include changes to menstrual cycles, skin changes, such as body hair and acne, abnormal growths in the ovaries, and infertility.

According to the World Health Organization, around 8% to 13% of women and girls of reproductive age worldwide have PCOS. However, as many as 70% may be experiencing PCOS while undiagnosed.

In the study, researchers analyzed data from 907 female participants who were between the ages of 18 and 30 at the start of the study. Among the participants, 66 met the criteria for PCOS. The participants were followed for 30 years and tested on their memory, verbal abilities, attention, and processing speed.

Overall, the researchers found that participants with PCOS scored an average of 11% lower on the attention test compared to participants without the condition. Participants with PCOS also scored lower on tests of memory and verbal abilities.

A subset of participants in the study also completed MRI scans to assess their brain structure and white matter integrity. Among the 291 participants who completed MRI scans, 25 met the criteria for PCOS. Participants with PCOS had white matter in poorer condition, which could be a sign of brain aging.

"Our results suggest that people with this condition have lower memory and thinking skills and subtle brain changes at midlife," said Heather Huddleston, director of the University of California, San Francisco's PCOS clinic and research program and the study's lead author. "This could impact a person on many levels, including quality of life, career success and financial security."

Commentary

According to Pauline Maki, a professor and director of the Women's Mental Health Research Program at the University of Illinois Chicago, the study is one of the few "to investigate cognitive functioning and brain outcomes in [women with PCOS] at midlife," and the findings highlight "potential cognitive vulnerabilities" in women with this condition.

Maki also noted that, "it's important to know that these are cognitive weaknesses, not impairments. In other words, they are performing worse than other women on these tests, but they are not performing in the impaired range."

Katherine Sherif, a professor of medicine at Thomas Jefferson University, said metabolic abnormalities associated with PCOS, such as insulin resistance, inflammation, and impaired glucose tolerance, may be contributing to accelerated cognitive aging in women with the condition.

"Essentially, what we could be seeing here is what happens when PCOS is left untreated," said Mateja Perović, a doctoral student in the department of psychology at the University of Toronto. "This is important for any concerned readers to keep in mind. If they are managing their PCOS symptoms, they are already doing a lot to protect their brain health down the line."

Health experts noted the study had several limitations and that its findings should be interpreted carefully. Notably, the participants were not diagnosed with PCOS by a physician. Instead, the criteria the study used for PCOS were high androgen levels and participants' recollections of symptoms.

Because of these limitations, Huddleston said additional research will be needed to confirm the findings and determine how the cognitive changes occur, "including looking at changes that people can make to reduce their chances of thinking and memory problems."

For individuals with PCOS who are concerned about their brain health, Maki recommended " controlling their diabetes, getting good exercise, controlling blood pressure, keeping their cholesterol levels in the healthy range and, perhaps (if) future research confirms these findings, maintaining androgen levels in the normal range as they age."

Other potential treatments for managing PCOS symptoms and brain health include improving sleep quality, building muscle strength, and talking to your physician about any helpful medications or supplements. (Rogers, CNN, 1/31; Taylor, Becker's Clinical Leadership, 2/1; Huddleston et al., Neurology, 1/31)

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