What’s the connection between psoriatic arthritis (PsA) and polycystic ovary syndrome (PCOS)? PCOS and psoriasis are linked, and those with PCOS are more likely to have more severe skin plaques if they do get psoriasis.

Having psoriasis also puts you at higher risk for PCOS.

PsA is a type of arthritis that affects about 1 in 3 people with psoriasis. Psoriasis causes red, scaly patches to form on the skin.

PCOS is a hormone imbalance. People with PCOS produce high levels of hormones called androgens. Androgens prevent the ovaries from making hormones and releasing eggs.

Let’s look at the reason behind the connection, and how both of these conditions are treated.

Language matters

Sex and gender exist on a spectrum. We use “women” in this article to reflect the term assigned at birth. However, gender is solely about how you identify yourself, independent of your physical body.

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Research shows that people with psoriasis are more likely to also have PCOS.

Experts say insulin resistance is the link between these two conditions. Insulin is the hormone that moves glucose (sugar) from your bloodstream into your cells to lower your blood sugar level after you eat.

When you have insulin resistance, your cells can’t pull insulin from your blood as easily. Your pancreas must make more insulin to lower your blood sugar level.

PCOS is also linked to insulin resistance, as high blood sugar can cause androgen levels to rise.

People with PCOS are more likely to have overweight, which makes their cells more resistant to the effects of insulin. Obesity and insulin resistance are also common in people with psoriasis.

Metabolic syndrome is another common condition in those with PCOS and psoriasis. It’s a cluster of factors that includes high blood pressure, high blood sugar, and excess body fat. Having metabolic syndrome increases your risk for chronic conditions such as diabetes and heart disease.

Psoriasis and PCOS have another thing in common: They’re both inflammatory diseases.

Tumor necrosis factor alpha (TNF-alpha) is an inflammatory protein that’s linked to both conditions. TNF-alpha can cause insulin resistance.

Autoimmune diseases happen when your immune system mistakes your healthy tissues for germs or other foreign invaders and attacks them. PsA is an autoimmune disease in which the immune system attacks the joints and skin.

PCOS doesn’t cause autoimmune disease, but it could be one. Many women with PCOS have low levels of the hormone progesterone. A drop in this hormone can stimulate the immune system to make autoantibodies — proteins that damage the body’s tissues.

In one study, women with PCOS were almost eight times more likely to have a positive antinuclear antibody (ANA) test than women without PCOS. A positive ANA test is a way that doctors diagnose autoimmune diseases.

PCOS can also coexist with other autoimmune diseases. Up to 40 percent of women with PCOS also have an autoimmune disease of the thyroid — the butterfly-shaped, hormone-producing gland in the neck.

Inflammation is your body’s natural response to injury and stress. When you injure yourself or have an infection, your immune system sends out white blood cells to fix the damage or fight the germs. White blood cells release chemicals that produce symptoms like pain, redness, and swelling.

Inflammation is helpful when you’re injured or sick. It’s not helpful when it becomes chronic or long-term. Chronic inflammation has been linked to a higher risk of heart disease.

Those with PCOS have chronic low-grade inflammation in their bodies. As evidence, they test positive for markers of inflammation like C-reactive protein and interleukin-18 in their blood.

An abnormal immune response causes chronic inflammation in PsA. Inflammation produces symptoms of the disease, including joint swelling, redness, and pain.

Inflammation may also be the reason for the link between PCOS, insulin resistance, and metabolic syndrome. And it could increase the risk of heart disease and blood vessel problems in the long term.

Treatments for PsA aim to prevent joint damage and relieve symptoms.

Nonsteroidal anti-inflammatory drugs (NSAIDs) bring down inflammation and ease pain and swelling. Disease-modifying anti-rheumatic drugs (DMARDs), including biologics, slow the disease process to stop joint damage.

The choice of PCOS treatment depends on:

  • how severe your symptoms are
  • your age
  • your health
  • whether you want to get pregnant

Medications for PCOS include:

  • birth control to make your menstrual cycle more regular and reduce symptoms such as acne and excess hair
  • anti-androgen drugs to block the effects of androgens and reduce excess hair growth
  • metformin, to prevent insulin resistance
  • medication to help with ovulation

Psoriasis and PCOS often go hand in hand. If you have one of these conditions, you’re more likely to have the other. The two conditions also share an increased risk of insulin resistance, heart disease, and diabetes.

Whether you have psoriasis, PCOS, or both, talk with your doctor about your risks. You may need to take extra steps to protect your health.