Focus on female health - long-term health outcomes related to common gynecological conditions like PCOS
Research group leader
- ProfessorTerhi Piltonen
Research group description
Main focuses of the research team are:
- To asses the role of different gynecological conditions in long-term health outcomes in women. Special emphasis in gynecological hormone-related disorders (PCOS and endometriosis)
- Unravel the role of AMH in PCOS pathogenesis
- To reveal mechanisms/pathways responsible for the altered endometrial function in PCOS
- To assess the inflammatory and metabolic effects of hormonal contraceptives
- To elucidate the role of inflammation, hypoxia and metabolism-related factors in endometrial regeneration and health - outcomes related to implantation and endometrial cancer
- To develop means and tools to increase awareness of female health and develop treatment guidelines
- Link with national and international research teams and patient organizations and other collaborations to improve equality and health in women
Polycystic ovary syndrome (PCOS) affects 10-18% of fertile aged women and it is characterized by hyperandrogenism and chronic oligo-anovulation. Up to 50-70% of women with PCOS are obese and the women present with metabolic derangements. Interestingly, some women will not present the clinical, diagnostic features (oligo-anovulation, hyperandrogenism) until gaining weight, thus the syndrome is tightly linked with obesity. Due to anovulation, some women have difficulties to achieve spontaneous pregnancy and most of the diagnosis are set in the infertility clinics. However, especially the obese women with PCOS would benefit lifestyle counselling, glucose metabolism testing and antiandrogenic treatments for excessive body hair even outside fertility context. Considering that the syndrome has been shown to associate with several co-morbidities (type 2 diabetes, hypertension, dyslipidemia, stroke, pregnancy complications, and endometrial cancer) and psychosocial burden (anxiety, depression, eating disorders), correct, timely diagnosis, early support and common guidelines are warranted.
Endometrial function in PCOS
The inner epithelial lining of the uterus, called endometrium, is a hormone responsive tissue which grows and sheds in response to fluctuating levels of ovarian-derived steroid hormones. Endometrium lining consists of simple columnar epithelium that is in tight connection with underlying stromal cells, enabling complex interaction between these two cell compartments. Resident and migrating immune cells are also important for the function of the endometrium. Interestingly, perivascular stem cell populations have also been identified in human endometrium possibly contributing to the monthly renewal of the endometrial lining. Women with PCOS have been shown to present with an altered endometrial function related to steroid hormone action and/or metabolism possibly contributing to infertility/subfertility as well as to endometrial cancer risk in women with PCOS. The Piltonen group aims to decipher the mechanisms of the endometrial dysfunction and how it affects implantation capacity and placentation in PCOS endometrium.
Effects of hormonal contraception on female health
Hormonal contraceptives, commonly used in treating women with PCOS and endometriosis but also many other gynaecological conditions, have crucial role in female hormone therapy. Besides well documented benefits, recent studies have indicated impairment in metabolic parameters (glucose and lipid metabolism and low-grade inflammation) in women with no previous risk factors. Whether some estrogen/progestin combinations are metabolically more beneficial and should thus be recommended to women with pre-existing unfavourable metabolic profile is not well established.
The epidemiological studies mostly based on both 1966 and 1986 Northern Finland Birth Cohorts (http://www.oulu.fi/nfbc/node/44315). The main interests of the epidemiological side are PCOS and endometriosis and their impact on health and quality of life of the affected women. During years 2020 - 2022 the Piltonen lab conducted a data collection for all women who are part of the Northern Finland Birth Cohort 1986. The aim of the collection is to improve health of women in their reproductive years and to study the incidence of health conditions, that affect Finnish women, e.g., PCOS, endometriosis, diastasis recti and ovarian aging. The collection is conducted in collaboration with Roche.
Where are we headed
Improve long-term health and wellbeing of women with PCOS and increase PCOS awareness
The most important collaboration partners
How to find us
Department of Obstetrics and Gynecology
Clinical Research Unit
Medical Research Center Oulu
Oulu University Hospital
University of Oulu, FINLAND