Polycystic ovarian syndrome increases the risk of subsequent early ovarian aging later in life.

Women with polycystic ovarian syndrome (PCOS) have 8.64 fold increase in risk of developing premature ovarian failure as compared to women who did not have PCOS according to a population based study in forthcoming issue of Journal Menopause. Metformin was found to be effective in reducing such risk. 

The study authors reviewed data across a period of 14 years (1998 to 2012) from Taiwan National Health Insurance Research Database.

The study group consisted of women with PCOS (exposure group; n=7,049), each woman with PCOS was age matched with 10 other women without PCOS. (contrast group; n = 70,490).

The cohort was followed up for 10 years. The diagnosis of POI and PCOD was confirmed by blood test and ultrasonography.

Polycystic ovary syndrome (PCOS) is an endocrinopathy that affects approximately 10% of reproductive-aged women throughout their lives and POI affects 1-3% of women by age 40.

It was seen that POI was nearly 8 times more common in women with PCOD. Kaplan-Meier survival analysis showed that POI free survival rates of women were significantly more in contrast group than exposure group (P < 0.001).

After adjustment of covariates, it was seen that women with PCOD have 8.31 fold increase in risk of developing premature ovarian failure, this was 9.93 fold for women who did not receive metformin treatment for PCOS.

Metformin was significantly effective in lowering the risk to nearly half (5.66).

However, well-designed, prospective, long-term, large-scale, randomized clinical trials are necessary to elucidate the efficacy and safety of long term metformin in patients with PCOS.  

The results of this study are in contrast to the earlier hypothesis that women with polycystic ovaries (PCO) are protected against POI because they may have actually been born with a larger pool of resting follicles.

Currently, PCOS and POI are both being investigated as diseases of autoimmune origin.