Is There a Connection Between PCOS and Psoriatic Arthritis?

Polycystic ovary syndrome (PCOS) is a condition in which multiple cysts form on one or both ovaries, leading to a wide array of symptoms and complications. Psoriatic arthritis (PsA) is an autoimmune inflammatory condition that can affect the skin, nails, joints, and spine.

It has been hypothesized in recent years that there might be a connection between PCOS and psoriasis, which leads some to wonder if the same could be true for PCOS and PsA.

This article discusses the link, if any, between psoriatic arthritis, psoriasis, and PCOS.

The Connection Between PCOS and PsA

PCOS is a condition that causes a variety of symptoms, including weight gain, excess body hair, menstrual period irregularities, and more. It is thought to be caused by hormonal imbalances.

Psoriasis is a chronic inflammatory skin condition that leads to the development of plaques and scales along the body, scalp, and nails.

Both PCOS and psoriasis have been tied to some level of insulin resistance and metabolic syndrome.

While the exact connection is not fully understood, there has been some evidence to suggest a link between PCOS and psoriasis. A 2013 study showed that people with psoriasis were at a significantly higher risk of developing PCOS.

Some evidence suggests a possible link between PCOS and psoriasis, but is there a link between PCOS and psoriatic arthritis?

About 30% of people with psoriasis develop psoriatic arthritis. A person with one autoimmune disease, such as psoriasis or psoriatic arthritis, is at a higher risk of developing additional autoimmune diseases when compared to the general population.

While limited studies have shown a connection between psoriasis and PCOS, there are no studies suggesting a link between PCOS and PsA.

Is PCOS an Autoimmune Disease?

Autoimmune diseases occur when the body's own immune system is mistakenly triggered and begins attacking healthy tissue and organs. For example, in psoriatic arthritis, the immune system attacks a person's joints, skin, nails, and more.

The exact cause of PCOS remains unclear. However, insulin resistance, high levels of androgens (a particular set of hormones), and irregular menstrual cycles can all contribute to PCOS.

Currently, there is no evidence to suggest PCOS is an autoimmune disease.

The Role of Inflammation in Both Conditions

Despite the lack of concrete evidence between PCOS and psoriatic arthritis, both conditions do share one characteristic with each other: the presence of inflammation.

People with PCOS tend to have higher sedimentation rates (ESR) or levels of C-reactive protein (CRP), both of which are markers of inflammation.

Inflammation has also been shown to lead to higher oxidative stress in PCOS.

PsA is characterized by inflammation in the joints and the surrounding synovial tissues.

Treatment for PCOS and Psoriatic Arthritis

Since people with PCOS tend to either not menstruate (amenorrhea) or have irregular menses (oligomenorrhea), the goal of treatment typically is to establish consistent and regular periods. In addition to weight loss, regular exercise, and lifestyle modifications, the following are some treatment options for PCOS:

• Clomid: An estrogen receptor modulator which can stimulate ovulation
• Metformin: A common diabetes medication which reduces insulin and androgen levels
• Gonadotropins: Hormones responsible for stimulating ovulation

In addition to medications to help stimulate ovulation, other medications or interventions may help reduce the varying symptoms of PCOS.

Thanks to advances in modern medicine, particularly with the development and improvement of biologic agents, there are numerous treatment options available for people with PsA. The goal of treating PsA is to reduce systemic inflammation and prevent or slow the progression of systemic disease.

Options for treating psoriatic arthritis include:

• Nonsteroidal anti-inflammatories (NSAIDs)
• Dietary and lifestyle modifications
• Oral or topical steroids
• Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and sulfasalazine
• Biologics, such as Remicade and Humira

When to See a Healthcare Provider

Untreated PCOS can lead to long-term complications and disease, including:

• Infertility
• Obesity
• Cardiovascular disease
• Endometrial cancer

It's important to seek an evaluation from a healthcare provider if you experience symptoms such as:

• Irregular periods
• Weight gain
• Excess body hair
• Acne
• Cystic ovaries

With early intervention and proper treatment, PCOS can be managed effectively.

Untreated PsA can also lead to increased disability and decreased quality of life. Seek a medical evaluation for possible PsA symptoms if you are experiencing:

• Swollen and tender joints
• Decreased range of motion of your joints
• Spinal tenderness and stiffness
• Psoriasis of the scalp, skin, or nails

Summary

In recent years, a handful of studies have investigated the possible link between insulin resistance and metabolic dysfunction in psoriasis and PCOS. While there is currently no evidence to support an association between PCOS and psoriatic arthritis, more research is needed to answer these questions. Both conditions can be effectively treated with the help of a healthcare provider.

A Word From Verywell

Both PCOS and PsA can be effectively managed with an appropriate treatment plan. If you are exhibiting symptoms of either disease, it's important to have a medical evaluation to ensure the best outcome for your health and future.