The PCOS and Liver Connection

You wouldn’t imagine that a condition in women’s ovaries could be related to the liver. But actually, significant research including a recent study done in 2018 found that women with a hormonal condition called polycystic ovarian syndrome (PCOS) were twice as likely to develop a liver disease known as non-alcoholic fatty liver [R]. Sounds wild, right? Let’s delve into this.

What is PCOS?

Polycystic ovarian syndrome is quite a common disorder, affecting up to 10% of women worldwide. It is mostly characterized by infrequent or prolonged menstrual periods, excessive androgen levels, or ovarian follicles. What causes it? The clear answer to this is unknown, but it does tend to run in families, and research demonstrates that excessive cortisol production and adrenal insufficiency is at play. There are also some hormone imbalances that seem to be connected to PCOS like excessive insulin. Insulin is the hormone that signals cells to take up sugar and use it for energy. Cells of PCOS patients respond less to insulin. In an attempt to overcome this, the body produces an excess amount of insulin, which leads to not only insulin resistance, but a whole range of other hormonal imbalances, such as the increase in testosterone levels [R] and weight gain. In addition, there is a strong link between PCOS and obesity, and obesity worsens PCOS symptoms.

Perhaps PCOS is most commonly addressed when planning a pregnancy, which is why when most people think of PCOS, they think of infertility. This is because difficulty conceiving is a common result of untreated PCOS.

The Liver Connection

Now that we understand PCOS a little bit more, let’s look at how it can affect the rest of the body, and in particular the liver. Polycystic ovarian syndrome is a metabolic disorder and patients diagnosed with it have a higher risk for developing several diseases including type 2 diabetes, hypertension, and cardiovascular disease [R]. This is due to the excessive insulin levels that are associated with PCOS.

Non-alcoholic fatty liver disease (NAFLD) is a disorder wherein excessive fat is stored in the liver that ultimately can lead to cirrhosis, or late stage liver damage. As mentioned above, women with PCOS are twice as likely to develop NAFLD and the mechanism behind this association is likely a complex interplay between excessive testosterone, insulin resistance, and obesity.

What can you do?

Focus on your essential fatty acids like avocados, salmon, and trout as these are high in omega-3 fatty acids which are effective at reducing inflammation, triglycerides, and insulin in women with PCOS. One study showed that PCOS women who were supplemented with 4 grams of fish oil for eight weeks had a significant decrease in liver fat- which helps reduce the risk of NAFLD development [R].

Take Home Message

It's quite a common misconception that women with PCOS need to only focus on hormonal balance when planning a pregnancy. However, it's important to take into account the metabolic changes that occur in PCOS patients and get more integrated health care throughout life. This also means women with PCOS should be screened often for NAFLD. If you’ve been diagnosed with any kind of hormonal condition – give your liver some love! Avoid high fat diets, drink less alcohol, and focus on consumption of your bitter greens, antioxidants, and low impact workouts.

‍