![]() In pregnant women with PCOS, use of metformin reduced the prevalence of late miscarriage and preterm delivery ( 19).īoth prolactin levels and breast increase in pregnancy may be useful as long-term risk markers for metabolic health in women with PCOS. According to the recent international evidence-based guidelines on treatment of PCOS, metformin could be considered in addition to lifestyle changes, to improve weight, hormonal and metabolic outcomes in adult non-pregnant women with PCOS ( 18). Metformin is an insulin-sensitizer and is the first drug of choice in type 2 diabetes. Obesity might thus be a major contributing factor to shorter breastfeeding in women with PCOS ( 17). A large cohort study from Australia showed similar results, but the association between short breastfeeding and PCOS diminished after adjustment for BMI. Shorter breastfeeding duration has also been reported in women with PCOS compared to women without PCOS ( 16). ![]() Breastfeeding duration is shorter in obese women, than in normal-weight women in the general population ( 14, 15). We have previously reported that lack of breast increase during pregnancy was linked to poorer metabolic health both in early and late pregnancy compared to women with breast increase among women with PCOS ( 13). Baseline prolactin was not associated to cardiovascular (CVD) risk profile at follow-up in women, around 40 years of age at inclusion, attending a longitudinal community-based cohort study on CVD risk factors ( 12). Furthermore, high prolactin within normal range was associated with lower prevalence of diabetes and impaired glucose tolerance in a large population-based cohort ( 11). In non-pregnant women with PCOS, prolactin within normal range was inversely associated with metabolic risk markers such as waist circumference, total cholesterol, triglyceride and low-density lipoprotein ( 10). As a physiological adaptation to the emerging insulin resistance in pregnancy, prolactin stimulates β-cell proliferation in pancreatic islets ( 9). However, the high number of women with GDM might be linked to higher BMI in women with PCOS ( 8).ĭevelopment and differentiation of the mammary glands and successive lactogenesis depend on prolactin. In PCOS pregnancies, increased risk of gestational diabetes mellitus (GDM), preterm birth and preeclampsia has been reported ( 5, 6, 7). These women are at increased risk of cardiovascular disease already during premenopausal years ( 4). Most women with PCOS have insulin resistance and hyperandrogenism ( 2, 3). Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in women, with implications mainly for reproductive and metabolic health ( 1).
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