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Umwelteinflüsse beim polyzystischen Ovarsyndrom

Environmental factors in polycystic ovarian disease

  • Leitthema
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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Hintergrund

Das polyzystische Ovarsyndrom (PCOS) stellt mit einer Prävalenz von 6–20 % eine der häufigsten Erkrankungen von Frauen im reproduktionsfähigen Alter dar. Das PCOS ist durch einen Hyperandrogenismus und eine chronische Anovulation charakterisiert und eng mit einer Insulinresistenz assoziiert. Frauen mit PCOS weisen Zyklusunregelmäßigkeiten, einen unerfüllten Kinderwunsch, äußerliche Veränderungen, wie Hirsutismus, Akne oder androgenetische Alopezie, sowie eine Adipositas auf. Die klinische Symptomatik führt zu einer deutlichen Einschränkung der Lebensqualität betroffener Frauen. Die Pathophysiologie des PCOS ist multifaktoriell. Über eine genetische Disposition hinaus scheinen auch verschiedene Umweltfaktoren Einfluss auf die Entwicklung zu haben.

Ziel der Arbeit

Dieser Beitrag beleuchtet den Einfluss ausgewählter äußerer Faktoren auf die Charakteristika des PCOS und soll die Frage beantworten, welche Rolle die uterine Umwelt, die Adipositas und endokrine Disruptoren wie Bisphenol A (BPA) in der Entstehung des PCOS spielen.

Ergebnisse und Diskussion

Tiermodelle mit pränataler Androgenisierung deuten darauf hin, dass die intrauterine Exposition mit Androgenen durch die Mutter zur Entstehung eines PCOS-typischen Phänotyps beitragen kann. Eine Adipositas ist wahrscheinlich nicht Ursache eines PCOS, jedoch eng mit ausgeprägteren Formen des PCOS assoziiert. Sie moduliert wesentlich das mit dem PCOS verbundene metabolische Risiko. Endokrine Disruptoren wie BPA verstärken möglicherweise den Hyperandrogenismus beim PCOS.

Abstract

Background

With a prevalence of 6–20 %, polycystic ovary syndrome (PCOS) is one of the most frequent endocrinopathies among fertile women. It is characterized by hyperandrogenism and chronic anovulation and is highly associated with insulin resistance. Women with PCOS suffer from menstrual irregularity resulting probably in subfertility and from hirsutism, acne, and androgenetic alopecia. Furthermore, obesity is common in PCOS. Women with PCOS report a significant decrease in quality of life. Multiple factors are involved in the pathophysiology of PCOS. Besides a genetic background, environmental factors seem to influence development.

Aim

This article outlines the role of selected environmental factors in the pathophysiology of PCOS and describes the influence of intrauterine exposure to androgens, obesity, and endocrine disruptors like bisphenol A (BPA) on the PCOS phenotype.

Results and discussion

Intrauterine exposure to androgen excess due to hyperandrogenism of the mother may lead to the development of the PCOS phenotype including metabolic derangements. Obesity does not seem to cause PCOS, but is highly associated with a more severe phenotype of PCOS and aggravates metabolic risks associated with PCOS. BPA may enhance androgen synthesis and activity.

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Authors and Affiliations

  1. Klinik für Endokrinologie und Stoffwechselerkrankungen, Zentrallabor – Bereich Forschung und Lehre, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland

    S. Reger-Tan & D. Führer-Sakel

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  1. S. Reger-Tan
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  2. D. Führer-Sakel
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Correspondence to S. Reger-Tan.

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S. Reger-Tan und D. Führer-Sakel geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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T. Strowitzki, Heidelberg

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Reger-Tan, S., Führer-Sakel, D. Umwelteinflüsse beim polyzystischen Ovarsyndrom. Gynäkologische Endokrinologie 13, 163–167 (2015). https://doi.org/10.1007/s10304-015-0014-6

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  • DOI: https://doi.org/10.1007/s10304-015-0014-6

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