Prenatal androgen exposure linked with polycystic ovarian syndrome risk

Daughters of women with polycystic ovarian syndrome (PCOS) are at five times greater risk of developing the condition, according to a new study published in Nature Medicine.

PCOS affects up to 17% of women of reproductive age and is associated with reduced fertility, type 2 diabetes and other detrimental health effects, such as irregular menstrual cycles (all of which can be exacerbated by obesity). Despite the high prevalence of the condition and the severity of the impact on women’s health, the causes and risk factors of PCOS are largely unknown. Previous studies have suggested that genetics alone accounts for only up to 10% of the heritability of the disorder.

Elisabet Stener-Victorin and colleagues analysed medical records of women with PCOS in Sweden and followed a cohort of Chilean women with PCOS and their daughters from a case - control study. They found that the daughters of both the Swedish and Chilean women with PCOS were five times more likely to be diagnosed with the disorder. To further understand the drivers of this effect, the authors also performed studies in mice. They found that prenatal exposure to androgen hormones, and not obesity in pregnancy, was responsible for the observed transgenerational effects and that these effects persisted and were passed on for up to three generations.

These findings unravel some of the complexity of this heterogeneous disorder and lay the foundation for further studies aimed at preventing PCOS in future generations of women.

doi: 10.1038/s41591-019-0666-1

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