Link Between PCOS and Idiopathic Intracranial Hypertension

The connection between polycystic ovarian syndrome (PCOS) and idiopathic intracranial hypertension (IIH) is a growing concern in women’s health, particularly for obese women of reproductive age. A comprehensive review published in the European Journal of Obstetrics and Gynaecology has delved into the prevalence and clinical implications of these two comorbid conditions. While PCOS is a well-known endocrine disorder characterized by hyperandrogenism and metabolic disturbances, IIH is a neurological condition marked by increased intracranial pressure without a detectable cause.

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The study reviewed data from several clinical trials and found that women with PCOS are significantly more likely to develop IIH compared to the general population, with some studies reporting an incidence rate of up to 57% in PCOS patients. This is markedly higher than the 4–10% prevalence of PCOS in the broader population, suggesting that shared risk factors, such as obesity and hormonal imbalances, may contribute to the concurrent development of both conditions. Obesity, in particular, appears to play a central role in linking PCOS with IIH, as it exacerbates intracranial pressure through increased abdominal and cardiac pressure. From a hormonal perspective, the excess production of androgens in PCOS patients may further elevate the risk of IIH. The review highlighted that both conditions share similar pathophysiological profiles, particularly concerning androgen excess, which could potentially contribute to the increased production of cerebrospinal fluid (CSF) and subsequent intracranial pressure in IIH patients.

 

The findings underscore the need for an integrated approach to managing women with PCOS who are at risk for IIH, focusing on weight management, hormonal regulation, and regular monitoring for neurological symptoms. The authors also emphasize the importance of early detection and intervention, as untreated IIH can lead to serious complications, including vision loss.

Journal Article: Rzewuska, N., Kunicki, J., Pieniak, K., Laskus, P., Zabielska, B., Smolarczyk, R., & Kunicki, M. (2024). A systematic review on idiopathic intracranial hypertension comorbid with polycystic ovarian syndrome and its consequences. European Journal of Obstetrics and Gynecology, 292, 1-7. https://pubmed.ncbi.nlm.nih.gov/37948928/

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