– PCOS is like a natural superpower and can give a sporting advantage. Gynecologist Åsle-Marit Ullern thinks so. She works as a specialist at Best helse. Here she welcomes many top athletes. But what exactly is PCOS – and how can the condition provide a sporting advantage? PCOS stands for Polycystic Ovary Syndrome and about 15 per cent of the female population has the syndrome. – The classic PCOS is characterized by obesity, acne and increased hair growth, explains Ullern. But PCOS can be so much more, and there are many degrees, the gynecologist points out. This is PCOS PCOS is a syndrome that affects approximately 15 per cent of women. The cause of the disease is unknown, but heredity and environment play a role. At least 2 of 3 criteria must be present to make the diagnosis of PCOS: Oligo-anovulation: menstrual cycles that occur less often than ten times a year or do not occur at all. Hyperandrogenism: high levels of androgens in the body, such as testosterone Polycystic ovaries: 20 or more egg follicles of a certain size. PCOS can develop from puberty. Diagnosis is usually not made until the woman is at least 19 years old due to overlapping physiological phenomena during the teenage years. Common consequences of the syndrome: High testosterone levels can cause unwanted hair growth on the face, chest, stomach, arms and legs, acne, hair loss on the head and naturally high muscle strength. Lack of ovulation can lead to difficulties in conceiving naturally. Higher blood pressure than other women, which makes one more prone to cardiovascular disease. Reduced quality of life and sex life, and more anxiety and depression. Miscarriage or premature birth. Sleep apnea. Treatment Weight loss and weight control through changed diet and exercise. 5-10 percent weight reduction produces clinically significant results on ovulation and pregnancy rate. Medicine: Birth control pills and progesterone tablets to regulate the menstrual cycle. Laser radiation for facial hair removal. Use of diabetes medicine (metformin) can provide better blood sugar control and some weight reduction. Source: The Norwegian Medical Association and the Norwegian Medical Encyclopedia. High number of top athletes with PCOS – In many sports you need a small excess of androgen to be the best, i.e. insulin and testosterone to build muscles. To be successful, you must have some of the qualities that you associate most with men – action and explosiveness, explains Ullern. And women with PCOS may have more of that than other women. – One has relatively more circulating free testosterone, says Ullern. SPECIALIST: Åsle Marit Ullern believes PCOS can be a natural superpower in explosive sports. Photo: Best Helse This is also confirmed by Eszter Ilona Vanky. She is a professor of medicine at NTNU and one of Norway’s foremost experts on PCOS. Vanky agrees that PCOS can be seen as a natural superpower in sports: – They often have testosterone values in the upper normal range, or slightly above. It increases muscle strength and endurance, and increases the production of red blood cells. Then, together with other prerequisites, one can perform well as an athlete. – This is not uncommon Several studies show that PCOS is a common condition in many top female athletes, and that it is the most common cause of menstrual disorders among Olympic athletes. A Swedish study showed that almost four out of ten female top athletes, who did not use hormonal contraception, had PCO (Polycystic ovary), which is one of the symptoms of PCOS. Ullern is not surprised by the number, and believes that up to 40 per cent of female athletes may have PCOS: – This is not rare. There are many athletes with PCOS, says Ullern, who has treated several athletes with the syndrome. The Swedish study concluded that athletes with PCOS performed better than other athletes in physical tests, in that they had a higher maximum oxygen uptake. – Historically, we see that PCOS has had many advantages for survival, and that it also has that in sports. We have a description of PCOS from 2000 years ago in ancient Greece. When we lived on the savanna, those with PCOS fared better, they were stronger and could run from the lion. They could defend their offspring and did not give birth as often, explains Vanky. EXPERT: Eszter Vanky. Photo: Frida J. Krüger – Doesn’t always match the ideal of women today The condition, which is best known for contributing to obesity, acne and increased hair growth, can therefore be an advantage in the world of sports. – It can be uplifting for someone with PCOS to hear – that it can be beneficial in sports? – It can be an encouragement. But it depends on the patient. Not everyone has the same starting point for playing sports, says Vanky. – There are many degrees of PCOS. Those we see in sports generally have a mild version, says Ullern and points out: – I am concerned that there are many positive things about being like this. It doesn’t always match the ideal of women today, but there are some advantages to having it. OPEN: Former national team player Therese Sessy Åsland has spoken openly about the diagnosis. Photo: NTB – In which sports do we see the most women with PCOS? – Football and handball. Generally in those sports where you need explosiveness and muscles. It is in many sports, says Ullern. – The challenge often comes when women who have been involved in sports put on weight when they stop exercising. The women who are in elite and top sports have a whole medical support system around them. But when they step down, one should be aware of it, Vanky believes. Earlier, soccer player Therese Sessy Åsland, among others, told news about the PCOS diagnosis: – It was tough. There are several challenges with PCOS. Among other things, women with the condition can struggle to have children. Handball player Veronica Kristiansen has been open about the PCOS diagnosis and the challenges she has encountered. Even she was scared when she got the diagnosis five years ago, when Kristiansen had neither menstruation nor ovulation. – It was tough, she declared to VG this summer. She was told that it could be difficult for her to get pregnant. – I was told that since I was the age I was (29 years old), and wanted to have children, I should get pregnant as soon as possible, Kristiansen told VG. GOLD WINNER: Veronica Kristiansen helped win Olympic gold for Norway in Paris this summer, probably a year after she became a mother for the first time. Photo: NTB She took a break from the national team to get help to have a child, and after a hormone injection she became pregnant. Today, the daughter she has with boyfriend Adam Devecseri is one year old. Vanky confirms that this is a common problem for women with PCOS, but underlines: – It is important to point out that those with PCOS become pregnant, but sometimes need medical help. Vanky says that the follow-up on a general basis has become increasingly better in this country. – The women must receive a diagnosis and follow-up. I think we are on a very good path. Many people can get a little better with optimal diagnosis and treatment. We have received funds from the Danish Medical Association’s quality fund and are creating an online course for GPs and general practitioners about PCOS. It is quite large and can lift a lot of people, explains the researcher. Published 17.09.2024, at 22.09
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