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Individuals with PCOS are 35% more likely to have a first child with autism spectrum disorder (ASD)[1] and have an increased likelihood of having autism themselves.[2],[3]  In this article we explore the link between PCOS and ASD.


ASD is a complex developmental condition that can impact an individual in many areas of their life.[4]  It is associated with challenges in social communication, restricted interests and repetitive behavior.[5]  Women with autism often go undiagnosed into adulthood, leading to poor self-esteem and mental health problems as they seek to mask their differences from others.[6]


PCOS is associated with insulin resistance, whereby the cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood.[7]  Find out more about PCOS and Insulin Resistance.  PCOS is also associated with hyperinsulinemia, elevated levels of insulin in the blood beyond what is considered healthy.[8]  Find out more about PCOS and Hyperinsulinemia.


Biological children of mothers with PCOS can therefore be exposed in utero (within the womb) to elevated levels of glucose and insulin. 


This exposure results in a number of genetic variations, changes in protein levels and the production of toxins.[9],[10]  A number of these mechanisms are believed to result in impaired neuronal connectivity, the extent to which neurons are connected through neural networks. 


This impaired neuronal connectivity negativity impacts cognition, the “mental action or process of acquiring knowledge and understanding through thought, experience and the senses”,[11] thereby increasing the risk of ASD in offspring. 


These effects can also be further exacerbated by gestational diabetes, which is more common in women with PCOS.[12]


Risk factors for ASD include:[13]

  • Gendered as assigned male at birth (AMAB) with boys being 4x more likely to be diagnosed with ASD as girls;

  • Close relatives, such as parent or sibling, with autism or another mental health disorder;

  • Some medical conditions, including Fragile X syndrome (genetic condition which causes intellectual issues), tuberous sclerosis (benign tumors in the brain) and Rett syndrome (genetic condition which constrains head growth);

  • Extreme premature birth (<26 weeks of pregnancy); and

  • Elevated age of parents.


Reviewed by Riya Ganguly PhD., MBA, ICD.D, expert on technology transfer, new venture development and research facilitation

Sources
[1] https://www.dazeddigital.com/beauty/article/56216/1/why-is-there-such-a-strong-link-between-pcos-and-eating-disorders
[2] https://pubmed.ncbi.nlm.nih.gov/30065244/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068102/
[4] https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder
[5] https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder
[6] https://www.uclahealth.org/news/article/understanding-undiagnosed-autism-adult-females
[7] https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance#
[8] https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/hyperinsulinemia/faq-20058488.
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068102/
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355780/
[11] https://cambridgecognition.com/what-is-cognition/
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6068102/
[13] https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

Want to learn more about mental health conditions related to PCOS? Check out the sections on ADHD, depression and anxiety.

Complications - Neurological

PCOS and Autism

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