An investigation of the potential effects of amitriptyline on polycystic ovary syndrome induced by estradiol valerate.
Histochemistry and cell biology
Polycystic ovarian syndrome (PCOS) is frequently observed in adolescent women and usually progresses with depression. The aim of this study was to examine the effects of amitriptyline (Ami), a drug used in the treatment of depression, in individuals with PCOS. Forty 12-week-old female Wistar albino rats were randomly divided into five groups: control, sham, PCOS, Ami, and PCOS + Ami. To induce the syndrome in the PCOS groups, a single dose of 4 mg/kg estradiol valerate was administered by intraperitoneal injection; 10 mg/kg Ami was administered by intraperitoneal injection for 30 days in the Ami groups. After 30 days, all the animals were sacrificed and blood, ovary, and brain tissues were collected and subjected to routine tissue processing. Stereological, histopathological analyses were performed on the ovarian sections, while luteinizing hormone (LH), follicle-stimulating hormone (FSH), catalase (CAT), and superoxide dismutase (SOD) levels were investigated in blood samples. The volume of the corpus luteum and preantral follicles increased in the PCOS group, while a decrease was determined in the number of antral follicles using stereological methods. Biochemical analysis revealed that FSH levels increased and CAT enzyme levels decreased in the PCOS group. Significant morphological changes were observed in ovaries from the PCOS group. The volume of the corpus luteum in the PCOS + Ami group decreased compared to the PCOS group. Serum FSH levels decreased in the PCOS + Ami group, while CAT enzyme levels increased compared to the PCOS group. Degenerative areas were also seen in the PCOS + Ami group ovaries. Ami administration was unable to sufficiently ameliorate the morphological and biochemical changes caused in the ovarian tissues by PCOS. In addition, this study is one of the few studies examining the effects of amitriptyline, an antidepressant frequently used in depression treatment of individuals with PCOS. We also observed firstly that use of amitriptyline caused PCOS-like ovarian morphology in healthy rat ovaries, while it had a healing effect by volume decreasing of cystic structures in the ovary with PCOS.
10.1007/s00418-023-02188-3
Reproductive and metabolic abnormalities in women taking valproate for bipolar disorder: a meta-analysis.
Zhang Lin,Li Hua,Li Shaoping,Zou Xiaoyi
European journal of obstetrics, gynecology, and reproductive biology
OBJECTIVE:We aimed to evaluate the relationship between valproate (VPA) and reproductive endocrine abnormalities in women with bipolar disorder. METHODS:We searched studies in electronic databases of China Biology Medicine disc, PubMed, and Embase. Two authors collected articles and extracted data independently. Meta-analysis was performed for polycystic ovary syndrome (PCOS) and its components. The mean difference (MD) and 95% confidence interval (CI) were used to compare continuous variables. The Mantel-Haenszel formula was used to calculate the odds ratio (OR). RESULTS:There were statistically significant differences between the VPA treated and non-VPA treated groups in PCOS (OR 6.74; 95% CI 1.66-27.32; P=0.00), menstrual disorder (OR 1.81; 95% CI 1.02-3.23; P=0.04), and hyperandrogenism (HA) (OR 2.02; 95% CI 1.11-3.65; P=0.02). There was no statistically significant difference between the VPA treated and non-VPA treated groups in PCO (OR 1.37; 95% CI 0.71-2.66; P=0.35). The overall risk of menstrual disorders, PCO, and HA in the VPA treated group was higher than in the non-VPA treated group (OR 1.75; 95% CI 1.23-2.47; P=0.00). The levels of total and free testosterone in the VPA treated group were higher than in the non-VPA treated group (MD 0.12; 95% CI 0.05-0.19; P=0.00; MD 0.14, 95% CI 0.07-0.21; P=0.00, respectively). CONCLUSIONS:VPA was associated with the elevated levels of testosterone and HA in women with BD.
10.1016/j.ejogrb.2016.04.038
Prevalence and characteristics of polycystic ovarian syndrome in patients with bipolar disorder.
Journal of affective disorders
BACKGROUND:Bipolar disorder (BD) is frequently accompanied by endocrine disturbances. We compared the prevalence of polycystic ovary syndrome (PCOS) and related reproductive disorders between drug-naïve BD patients and matched healthy controls (HCs) and between drug-naïve BD patients and BD patients with long-term medication, as well as the clinical metabolic correlates among BD patients. METHODS:72 drug-naïve BD patients, 98 HCs, and 72 BD patients with long-term medication were recruited in the study. Menstruation was recorded, reproductive hormone levels and metabolic indicators were measured, and a pelvic ultrasound examination was performed via transvaginal sensor for each participant. PCOS was defined using the Rotterdam criteria. RESULTS:After controlling for demographic variables, drug-naïve BD patients presented higher rates of PCOS than the HCs (OR: 3.02, 95 % CI: 1.09-8.36). Regression analysis showed that long-term treatment with valproate (OR: 3.89, 95 % CI: 1.13-13.37), age (OR: 0.37, 95 % CI: 0.14-0.95), and insulin resistance index (OR: 1.73, 95 % CI: 1.10-12.71) were correlated with PCOS in BD patients. CONCLUSIONS:Drug-naïve BD patients are susceptible to developing PCOS, and valproate is correlated with increased occurrence and development of PCOS. Therefore, PCOS in BD patients, especially those who use valproate, needs to be investigated and monitored closely by medical personnel.
10.1016/j.jad.2023.08.007
Polycystic Ovary Syndrome, Affective Symptoms, and Neuroactive Steroids: a Focus on Allopregnanolone.
Current psychiatry reports
PURPOSE OF REVIEW:To provide an overview of existing studies on alterations in gonadal and neuroactive steroids (NASs) and mood symptoms among women with polycystic ovary syndrome (PCOS). RECENT FINDINGS:Recent studies have demonstrated a previously underappreciated association between PCOS and comorbid depression and anxiety. However, most studies on affective symptoms among women with PCOS have been cross-sectional, limiting our knowledge about fluctuations in symptoms over the menstrual cycle and reproductive lifespan for women with PCOS, as well as the potential interplay between NAS alterations and mood symptoms. Changes in the NAS allopregnanolone (ALLO) have been implicated in several reproductive-related psychiatric disorders (e.g., premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD)) as well as in normal reproductive functioning, warranting further investigation for its potential role in the psychiatric symptoms observed in women with PCOS. Prospective studies evaluating associations between psychiatric symptoms and NAS are needed to elucidate the biological causes of the increased rates of psychiatric symptoms among women with PCOS and inform clinical treatment. ALLO, with its role in normal reproductive function, menstrual dysregulation among women with PCOS, and reproductive-related psychiatric conditions, makes it a particularly intriguing candidate for future investigation.
10.1007/s11920-021-01244-w
Neuroendocrine, neurotransmitter, and gut microbiota imbalance contributing to potential psychiatric disorder prevalence in polycystic ovarian syndrome.
F&S reports
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, affecting up to 15% of reproductive-aged women. Polycystic ovarian syndrome is a heterogeneous disorder, both in the sense that many different factors may play a role in its manifestation and that multiple systems throughout the body can be affected. Polycystic ovarian syndrome has been linked to an increased prevalence of various psychiatric disorders, including depression and anxiety. Despite the socioeconomic effect that these disorders may have on patients with PCOS and society as a whole, this association is largely lacking in research. There are currently several theories regarding the link between PCOS and mental health. Some suggest that the overactive hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes in PCOS patients may alter the hormonal profile and contribute to the development of psychiatric disorders. Other studies speculate that abnormal levels of neurotransmitters and neuronal signaling may play a role. Recently, more research has begun to focus on the gut-brain axis, addressing the nutritional needs of PCOS patients. Studies show that dietary factors such as probiotics and micronutrient supplementation may significantly improve psychiatric symptoms in PCOS patients while helping regulate neurotransmitter levels in the body. In this review, we examine different theories regarding the association between PCOS and psychiatric disorders and point out different areas of research that are needed to broaden our understanding of this association.
10.1016/j.xfre.2023.08.009
PCOS and Depression: Common Links and Potential Targets.
Reproductive sciences (Thousand Oaks, Calif.)
PCOS or polycystic ovary syndrome is a common endocrine disorder that occurs during the reproductive age in females. It manifests in the form of a wide range of symptoms including (but not limited to) hirsutism, amenorrhea, oligomenorrhea, obesity, acne vulgaris, infertility, alopecia, and insulin resistance. The incidence of depression in PCOS population is increasing as compared to the general population. Increased depression in PCOS significantly alters the quality of life (QOL) of affected females. Also, self-esteem is found to be low in both depression and PCOS. The loss in self-esteem in such patients can be largely attributed to the associated factors including (but not limited to) obesity, acne, androgenic alopecia, and hirsutism. The reason behind the occurrence of depression in PCOS remains elusive to date. Literature suggests that there is an overlap of clinical symptoms between depression and PCOS. As the symptoms overlap, there is a possibility of common associations between depression, PCOS, and PCOS-associated abnormalities including insulin resistance (IR), obesity, CVD, and androgen excess. Studies demonstrate that depression is an inflammatory disorder marked with increased levels of inflammatory markers. On the other hand, PCOS is also regarded as a pro-inflammatory state that is characterized by increased levels of pro-inflammatory markers. Thus, there is a possibility of an inflammatory relationship existing between depression and PCOS. It is also possible that the inflammatory markers in PCOS can cross the blood-brain barrier (BBB) leading to the development of depression. Through the present review, we have attempted to shed light on common associations/shared links between depression and PCOS with respect to the levels of cortisol, androgen, vitamin D, neurotransmitters, monoaminoxidase (MAO), and insulin-like growth factor-1 (IGF-1). Tracking down common associations between depression and PCOS will help find potential drug therapies and improve the QOL of females with depression in PCOS.
10.1007/s43032-021-00765-2