PCOS: What it is and why it increases the risk of COVID-19

Some people with a uterus and ovaries have polycystic ovarian syndrome (PCOS) and don't even know it.

PCOS is the most common cause of infertility due to ovulatory abnormalities. Nebraska Medicine University Health Center health care provider, Lindsay O’Meara, PA-C, says it can be tricky to uncover, because two people with PCOS can have vastly different symptoms and experiences.

Common symptoms that may point to PCOS include:

  • Excessive hair growth (hirsutism) on chin and upper lip
  • Thinning hair and hair loss from the head (frontal and vertex, mainly)
  • Obesity
  • Acne
  • Irregular periods or no periods at all
  • Insulin resistance or diabetes
  • Mood disorders (increased anxiety and depression)
  • Sleep apnea

Several PCOS symptoms are caused by increased levels of hormones called androgens. Androgen hormones are present in both people assigned female and male at birth but are generally higher in males.

The link between COVID-19 and PCOS

PCOS has strong ties to conditions that put people at higher risk for severe COVID-19, like obesity, diabetes and heart disease. Learn more about comorbidities.

One U.K. study found that women with PCOS have a 51% increased risk for COVID-19 infection, compared to others their age who did not have PCOS.

But the researchers wanted to know if overlapping comorbidities, or something about PCOS itself, was the reason for the increased risk.

After adjusting for risk factors – like age, BMI, hypertension and cardiovascular disease – a person with PCOS still had a 28% higher risk of COVID-19 infection, according to the study.

Why exactly PCOS and COVID-19 can be linked is still a mystery. We know PCOS is associated with chronic inflammation and increased cytokines. Likewise, an inflammatory overreaction called a "cytokine storm" can cause long-lasting damage in COVID-19 patients.

Additionally, hormonal imbalance is a key PCOS feature. It's possible that excess androgens and insulin resistance are affecting the immune system's ability to fight off viral infections like COVID-19. More research is needed to understand how having PCOS can affect outcomes like COVID-19 infection and disease severity.

While researchers continue to tease out the underlying causes of worse COVID-19 illness, it's a good idea to stay safe in the meantime. A COVID-19 vaccine is a safe, effective way to prevent severe outcomes, like hospitalization and death.

How to treat PCOS

There's no way to "cure" PCOS, but treatments and lifestyle changes can manage the symptoms. For example, hormonal birth control pills, topical creams and oral medications may help reduce abnormal hair growth.

If you want to get pregnant, PCOS can lower fertility, although some people with PCOS can get pregnant without medical assistance. Medications can help here, so see your doctor if you're trying to conceive.

If you suspect you have PCOS or would like to talk to a doctor about it to learn more, call 402.472.5000 to schedule a gynecological appointment at the University Health Center.