Is there a link between PCOS and Autism?

By Clare Goodwin

Last updated: September 3, 2020

Does PCOS (or high testosterone levels) increase the risk of having a child with Autism?

I’ve been asked this a lot lately due to some research that has been released, so I wanted to answer all your questions.

In summary, the research shows that if you have PCOS, you have a greater risk of having a child with Autism. But I’m not in the game of scare mongering, so let’s look at what the actual risk is, and how we might reduce our risk. But first, a bit of background.

What’s the link between PCOS and having a child with Autism?

Firstly, let’s take a step back and look at what PCOS is. There is not one PCOS – we are all different, both in terms of our symptoms, but also the genes that predispose us to developing PCOS and the factors in our environment that turn on these genes.

However what’s common among most of us with PCOS, is that we have high levels of testosterone, DHEA-S and/or androstenedione which make up the androgen family of hormones.

These are sometimes referred to as the ‘male’ hormones, as males have more testosterone than females. But testosterone is crucial for females too – we need for strong bones and also the ever important libido among other things.

However, in excess, the androgens cause some issues for us. They cause acne, irregular periods, facial and body hair, hair loss and this is also likely what accounts for the high rates of autism in PCOS.

High levels of testosterone (among other hormones like cortisol), have been associated with autism in both male and female children.  It’s thought that these levels of androgens change the way the brain develops which produces a brain that’s very similar to the brain of an Autistic person.

When researchers looked at exposure to high androgens in the womb, they found that women with PCOS had 35% increased odds of having a first-born child with autism, and this was after taking into account other things that could potentially cause this, like diabetes, complications in childbirth and the mothers psychiatric state.

This isn’t the first study of this kind either. Swedish researchers in 2016 found that Maternal PCOS increased the odds of having a child with autism by 59%.

Is this research really true?

It is, but be aware that these studies are what we call a correlational study – the researchers looked historically at the correlation between PCOS and having a child with Autism. This doesn’t prove that PCOS causes Autism, and it might be something that they haven’t thought about to account for it.

To categorically prove it, we’d need to have a study where we took a bunch of women who were all exactly the same, and increase testosterone in half of them and then see how many of their children have Autism. But as you can imagine, there are some pretty major ethical issues with this, so we might be waiting a while.

Are we all destined to have Autistic children?

Absolutely not!

The risk of having an autistic child is quite low, only 1-2 percent in women who don’t have PCOS. So even though the risk increases by 49% in women with PCOS, that’s still only 1.5-2.5% chance So pretty slim.

Secondly, and very importantly, there is a lot that we can do to reduce our androgen levels by changing the way we eat, sleep, move and live and this could possibly likely our risk. However, our doctors aren’t trained in these methods, so you might not have been told how much more than to ‘go away and lose weight’ which is highly frustrating!

Lifestyle before drugs?

It’s research like this, and also other research that shows babies exposed to hight levels of insulin in the womb are also more likely to develop metabolic syndrome (obesity and insulin resistance) that makes me even more passionate about fixing your hormones by treating your ‘type’, before we resort to IUI medications like Clomid, Letrazole or IVF.

If you’re not getting pregnant, it’s generally because you’re not ovulating or producing fertile mucus – both of which are essential to get pregnant. And the reason for this is most likely because your Androgens (Testosterone and the like) are too high

As I’ve seen time and time again, when we figure out why you’re over producing these androgens i.e. your insulin levels, stress hormones, inflammation, thyroid etc, and then we can match you with a treatment plan to suit and bring down your androgen levels, we can see you ovulating again in a matter of months. Additionally we also see these androgen levels drop significantly.

Whereas if we just go and pump you with drugs like Clomid to force you to ovulate, then we’re doing nothing to bring down these testosterone levels.

I’m definitely not anti-medications, they are really helpful in cases and I’ve seen them used really effectively for many of the women I work with. But the difference is that I want to help you first do everything you can to treat the underlying issue that might be stopping you from ovulating and in turn bring down the testosterone levels.

The problem with our current medical model is that your average doctor, OBGYN or fertility specialist are not trained in nutrition and lifestyle strategies to bring down these androgen levels.  They can only offer what they have in their ‘kit bag’ and this is pharmaceutical interventions.

So how do we reduce androgens naturally?

There are so many different strategies we can use to help you reduce your androgen levels naturally.  But the first step is to find out why your body is overproducing these.  While you may have read that our genes are responsible, that is only partially true. We by no means know everything that contributes to PCOS.  But we do know that genes can be turned on and off by factors in our lifestyle and environment, and a few of these can contribute to PCOS. Some of these factors in PCOS are:

  • High blood sugar or insulin
  • High stress
  • Environmental toxins like plastics and pesticides
  • Chronic inflammation
  • Hypothyroidism

You can read more about how these factors contribute to PCOS in this article.