Is Your PCOS Caused By a Brain Tumor? Read On to Learn the Missing Link

Well, maybe. What we can say today is there may be a link between PCOS and brain tumor. However, we should wait for at least a few years before we can come up with a conclusion. In this article, we will attempt to find if a brain tumor causes PCOS. Before we embark on the journey, let’s first revise our knowledge about PCOS and brain tumor.

Understanding PCOS and Brain Tumor

Most probably, you would not need a detailed explanation of this common women health issue. Still, updating the information is always fruitful. PCOS, an acronym for Polycystic ovary syndrome, is a complex disorder of hormone imbalance. It affects up to 10% women in their childbearing years. Women with PCOS tend to have high levels of a male hormone (androgen), testosterone, in their body. As a result, they experience a multitude of health problems that include:

• Irregular or missed periods.
• Hormonal acne.
• Excessive hair growth on the face and body. It is called hirsutism.
• High blood sugar levels as the cells fail to utilize the hormone insulin. This condition is called insulin resistance (IR), a predictor of type 2 diabetes in future.
• Loss of hair from the scalp.
• Excess weight and trouble losing weight despite some serious efforts like dietary changes and increased physical activity.
• Failure to become pregnant (infertility).
• Mental depression.

PCOS and brain tumor, How is there a link?

A brain tumor refers to an abnormal mass of cells in or near the brain. It may be cancerous or non-cancerous. If a tumor begins in the brain, it is called a primary tumor. On the other hand, some tumor cells may travel from other parts of the body and reach the brain. It is known as a secondary or metastatic tumor. When you have a brain tumor, you may experience one or more of the following symptoms.

• Headaches that are increasingly painful.
• Nausea or vomiting without a relatable cause.
• Visual disturbances such as blurry or double vision
• Troubled decision making in day-to-day activities.
• Changes in behavior.
• Convulsions not previously known.

Brain tumor might be the link to hormone imbalance

Not to forget that the patients may experience many symptoms other than those mentioned above. Because your brain regulates hormone balance in your body, a brain tumor will likely cause problems with changes in the hormone levels. Simply put, the brain houses a master gland called pituitary gland. It releases certain hormones that regulate the hormonal secretions from other glands that are far from the brain. For example, the pituitary gland secretes the hormones FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone). Both FSH and LH control the secretion of estrogen, progesterone, and testosterone in women. That said, everything from menstruation, female sexual characteristics to fertility are under the control of the pituitary secretion. Now, imagine how would a pituitary tumor affect your health and hormone balance?

PCOS and brain tumor: the connection

According to the World Health Organization (WHO), there are more than 120 types of brain tumors. Considering this, it is a seemingly impossible task to link PCOS with a specific type of brain tumor. Thus, we decided to explore the potential association between a pituitary tumor called prolactinoma and PCOS. Interestingly, the results from various scientific studies suggest a possible link could exist. Continue reading till the end so that you do not miss the key points. Prolactinoma is a kind of pituitary tumor that causes an excessive secretion of a hormone called prolactin. In fact, prolactinoma is very common and accounts for more 40% of total pituitary tumor cases.

Common symptoms of hyperprolactinemia (increased blood levels of prolactin) include:

• Irregular or missed menstrual periods.
• The release of milk-like discharge from the breasts even when you are not pregnant or breastfeeding.
• Pain during sexual intercourse, which results from the lack of vaginal fluids.
• Acne and excessive hair on the body and face (hirsutism).
• Fertility problems.

Did you notice some symptoms common to both PCOS and prolactinoma? Yes, you got the first key. Congrats! Now, the Link For this, we have to go a bit back to the history. In 2009, a study published in Internal Medicine found that a single woman could have both hyperprolactinemia and PCOS. It was a case study and the researchers concluded that though rare, PCOS and hyperprolactinemia may co-exist.

What studies tell us about brain tumor and PCOS

The researchers examined a 33-year old lady who had been diagnosed with PCOS and hyperprolactinemia at the time of the study. Her major symptoms included:

• Irregular periods.
• Obesity.
• Hirsutism.
• Infertility.

Surprisingly, her testosterone levels were found to be normal during the course of the study. What does this suggest? This points out to a new direction in the diagnosis of PCOS. How could a woman experiencing PCOS symptoms have normal androgen level? Doesn’t this look counter-intuitive to whatever we know about PCOS for these many years? It’s high time we start looking at a complex disorder with a broader vision so that we don’t miss the keys. Here are some more revelations to follow.

• According to the researchers, 15-20% of the women with PCOS have a slight increase in prolactin levels that may not be considered hyperprolactinemia. Meaning, even without a pituitary tumor (prolactinoma), a PCOS patient can have elevated prolactin levels.
• At the time of the study, which is 2009, there were only 10 documented cases that linked PCOS and prolactinoma. However, this does not take away the possibility of the link. In fact, we can expect more studies in the future to uncover the truth.

PCOS may originate from beyond the ovaries

Yeah, you heard it right. The study suggests PCOS might originate in the brain rather than the ovaries. It was published in the Proceedings of the National Academy of Sciences (PNAS) in February this year. According to the study, it’s not just the testosterone levels that determine whether you will have PCOS or not. In fact, PCOS seems to be more reliant on the androgen receptors (ARs) that are present in the brain. The investigators concluded that:

• Mice with no ARs in their brains cannot develop PCOS.
• Those with no ARs in the ovaries can still develop PCOS.

Note: ARs are the sites where androgens including testosterone bind and show their biological actions. They are present in the muscles, ovaries, liver, and brain. Key Takeaways

• PCOS is a complex disorder. We know its symptoms but we are still far from knowing its exact cause. High testosterone levels could be just the tip of the iceberg.
• The possible link between PCOS and brain tumor could pave a new approach to finding a cure for this common women health issue.
• Hormonal therapies are the most commonly prescribed treatments. However, the results are not satisfactory in many cases. Thus, understanding the news ways of its origin could help in finding a cure or, at least, a better treatment.

Article References

1. Yavasoglu, I., et al. “Polycystic ovary syndrome and prolactinoma association.” Internal Medicine 2009;48(8):611-3. Epub 2009 Apr 15.
2. National Brain Tumor Society, TUMOR TYPES: UNDERSTANDING BRAIN TUMORS.
3. Caldwell, ASL., et al. “Neuroendocrine androgen action is a key extraovarian mediator in the development of polycystic ovary syndrome.” Proceedings of the National Academy of Sciences 2017 Apr 18;114(16):E3334-E3343.

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