The impact of hormones on emotional and social development: a study in adolescent daughters of women with polycystic ovary syndrome

TL;DR

Adolescent daughters of women with PCOS show emotional and social difficulties linked to early hormone exposure.

Contribution

This study identifies hyperandrogenism's impact on emotional and social development during critical brain development periods.

Findings

Daughters of PCOS women show higher negative affect and socio-emotional problems.

Hyperandrogenism exposure correlates with worse emotional recognition and prosocial behavior.

Early hormone exposure is linked to altered brain plasticity and mental health risks.

Abstract

Polycystic Ovarian Syndrome (PCOS) is the most prevalent endocrine disorder in adolescents. It affects brain maturation, specially in highly neuronal plasticity periods However, there is a lack of information about the impact of this exposure during brain plasticity windows.

Characterize the consequences of hyperandrogenism in emotional status and social cognition (SC) on adolescents daughters of women with PCOS (dPCOS).

Analytical cross sectional study. dPCOS and controls between ages of 12 to 25 years old were recruited. Participants underwent a complete clinical evaluation, plasmatic hormones determinations (including total testosterone, SHBG, androstenedione and 17-OH-progesterone) and ovarian ultrasound characterization. SC was estimated by: measurements of affects (PANAS), strength and difficulties (SDQ), self-reported empathy (EQ/SQ and AQ), and gaze patterns for autonomic response measurement via Eye-Tracking.

33 participants were recruited, 15 cases and 18 controls. Median age was 17 and 18 years, respectively. The dPCOS presented a larger anogenital distance (cm) (9.7 vs 7.8; p=0.014), Ferryman-Gallwey score mean (13.0 vs 2.0; p=<0.001) and free androgen index value (7.5 vs 4.1; p=0.004), suggesting hyperandrogenism exposure during intrauterine and adolescence periods. Regarding SC, dPCOS exhibited a predominantly negative affective status (PANAS 8.0 vs 2.0, p=0.049) and a higher score in socio-emotional problems (SDQ 2,5 vs 1,5; p=0,047). The eye-tracking registration showed that dPCOS presentes longer time to first fixation in areas of interest (s) (0,35 vs 0,28; p=0,037), which was associated with a worse endpoint in emotional recognition (aR2=-0,920; f=19,48; Pr >|t|=<0,049). Furthermore, the 2D:4D ratio (intrauterine marker of androgen exposure) was correlated with a predominance of negative affect (rho=0,51; p=0,019) and less prosocial behaviors (coef=-2,39; P>|t|=0,049).

Clinical and hormonal markers suggest that dPCOS are exposed to hyperandrogenism during the most critical neuroplasticity periods. This exposure is associated with negative affects, more social-emotional difficulties and less score on emotional recognition and prosocial behavior. Due to a high psychiatric comorbidity in PCOS patients, these findings are relevant and emphasize the importance of early mental health treatment in these patients.

None Declared