Linking Hidradenitis Suppurativa and Polycystic Ovary Syndrome: Insights and Additional Info
Two common health conditions, Hidradenitis Suppurativa (HS) and Polycystic Ovary Syndrome (PCOS), have been found to be linked as comorbid conditions. HS often occurs alongside PCOS, along with other inflammatory and metabolic disorders.
Understanding Hidradenitis Suppurativa
HS is a chronic inflammatory skin disease characterized by painful abscesses, nodules, and tunnels primarily in areas where skin rubs together, such as the groin, armpits, breasts, and buttocks. The condition is thought to be caused by genetic factors involving immune dysregulation and autoinflammatory pathways, with specific genetic loci like SOX9 and KLF5 implicated.
The disease leads to recurrent painful lumps, abscesses, and scarring. There is no cure for HS, but treatment focuses on symptom management, controlling flare-ups, and reducing pain. This can involve antibiotics, anti-inflammatories, steroids, immunosuppressants, biologic medications, surgical removal of affected skin and tunnels in severe cases, and pain management combining medication and lifestyle modifications.
Understanding Polycystic Ovary Syndrome
PCOS is an endocrine disorder characterized by hormonal imbalance, including hyperandrogenism (excess male hormones), irregular menstrual cycles, and polycystic ovaries. PCOS accounts for about 70% of hyperandrogenism cases.
The connection between PCOS and HS may involve shared inflammatory and hormonal pathways, as both conditions can involve systemic inflammation and insulin resistance. PCOS symptoms include irregular periods or anovulation, excess androgen effects like hirsutism (excess hair growth), acne, obesity, or insulin resistance in many patients.
Treatment for PCOS focuses on lifestyle modification, insulin-sensitizing drugs, and hormonal contraceptives. Lifestyle modification aims to improve insulin sensitivity and body composition, while insulin-sensitizing drugs like metformin lower insulin and androgen levels, improving menstrual cycles and reducing symptoms.
The Connection Between HS and PCOS
- Both HS and PCOS are linked to chronic inflammation and hormonal dysregulation, especially involving androgen hormones and insulin resistance.
- HS has a higher prevalence among women with PCOS, suggesting overlapping pathogenetic pathways.
- Managing systemic inflammation and metabolic syndrome components may benefit both conditions.
In clinical practice, managing a patient with both HS and PCOS involves multidisciplinary care addressing hormonal therapy and insulin resistance control for PCOS, antibiotics, biologics, and surgical options for HS symptom control, and lifestyle interventions to reduce obesity and inflammation.
As genetic and molecular studies continue to shed light on shared mechanisms, the understanding of the connection between HS and PCOS continues to evolve. It's worth noting that having HS may increase a person's risk of developing PCOS, and experts generally recommend that people with HS undergo screening for PCOS.
While there is no cure for either HS or PCOS, treatments can help reduce symptom severity, slow or prevent progression, and prevent complications. A treatment plan for HS typically includes skin care, medications, procedures, wound care, pain management, mental health care, and a combination of approaches for home treatment. PCOS care often involves a combination of medications and home care, with treatment approaches including weight loss or management, hair removal, treatments to slow hair growth, hormonal birth control, anti-androgen medications, and metformin to regulate insulin and androgen levels.
