What Is the Connection Between Hidradenitis Suppurativa and Polycystic Ovary Syndrome?

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Hidradenitis suppurativa (HS) is a painful, chronic inflammatory condition that causes painful lumps under the skin. The lumps can break open, and tunnels can form under the skin. Living with the condition can be emotionally and physically debilitating.^1-3

The exact cause of HS is still unknown, but doctors and researchers think genetics, inflammation, and hormonal imbalances all factor in disease development and progression.^4,5

What we know about hidradenitis suppurativa:^4-8

HS affects females about 3 times more often than males
HS changes with hormonal fluctuations during the menstrual cycle and pregnancy
Excess weight, stress, hormonal changes, heat, and humidity may worsen HS symptoms

The complex and often frustrating disease frequently coexists with other health conditions like polycystic ovary syndrome (PCOS). This is known as a comorbidity, which a term used to describe when 2 or more disorders appear in the same person.²

Understanding PCOS

Polycystic ovary syndrome is a complicated disorder that affects 1 in 10 women of childbearing age. Women living with PCOS have an imbalance of sex hormones, cysts on the ovaries, irregular menstrual periods, and metabolism problems. Those irregularities can change a woman’s appearance, overall health, and her ability to have children.^9-11

What we know about PCOS:^9-12

PCOS only affects women
PCOS is marked by an imbalance of reproductive hormones
PCOS is 1 of the most common causes of infertility
Genetics and weight play a role in who gets the disorder
Excessive facial and body hair is a normal symptom

While the exact cause of PCOS is unknown, research suggests that an overproduction of androgens, often called male sex hormones, contribute to disease development. Data shows women with PCOS have more androgens than normal.^9,10,12,13

Are HS and PCOS connected?

There is no simple answer to this question. Researchers have linked PCOS to HS, but their link is still being explored.^7,14

Both disorders are quite complex, and their relationship could be just as complicated.

What we know about PCOS and HS:^6,8,14

PCOS is more common in women with HS
Odds of having PCOS are about 2 times higher in women with HS
Around 9 out of every 100 people living with HS also have PCOS
Inflammation is a contributor to PCOS and HS
Genetics are a factor in both disorders

Could sex hormones be the link?

We know androgen overproduction is a potential source for PCOS, and some studies suggest sex hormones could play a role in the development of HS.^6,7

Are there any treatments that could help?

The American Academy of Dermatology suggests treatment for HS should be individualized, with a person’s other health conditions taken into account.⁸

Hormonal imbalances affecting HS are still under review, but certain therapies targeting hormones show promise. As we learn more about HS and its overlapping conditions, it appears that HS disease affects multiple body systems, not just the skin.^2,8

Both PCOS and HS have responded to anti-androgen treatment. Some drugs that target hormones include:^6,7,13,14

Hormonal birth control pills containing ethinyl estradiol and norgestrel
Spironolactone (Aldactone)
Finasteride (Propecia, Proscar)

These therapies are not necessarily FDA approved for treatment in both conditions.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The HSDisease.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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CommunityMember8bea90 Member

Yes, I understand this. I have multiple Autoimmune conditions and now at age 74, I have been managing them now since I was age 13/14. In my childhood and teen years I had no support in my family for this In fact it was never once discussed or treated by any physician. I have learned through my own research and experiences that if one does not get an Autoimmune condition treated and managed another one typically comes along about every decade. This is why education oneself and changing ones diet and lifestyle is so critical. Of course only in recent years has Autoimmune and auto-inflammatory Conditions been researched and better understood. 
1. christine.laaksonen Community Admin
 
 <inline-mention username="CommunityMember8bea90" user-id="9963403"/> you bring up such a good point about autoimmune conditions liking to "collect". Unfortunately, it is not uncommon for someone with an autoimmune disease to end up developing another (or more). Here's an article with some information on possible comorbidities to HS, <a rel="noopener noreferrer nofollow" href="https://hsdisease.com/manage-comorbidities">https://hsdisease.com/manage-comorbidities</a>. I am sorry to hear that your family was no support during your childhood and teen years. What a challenging time that must've been, especially at that age! How are you managing currently? Have you been able to find something that is helping you get some relief? (I see from your other comment that it is perhaps both you and your son are living with HS?) Sending you gentle hugs. -- Warmly, Christine (Team Member)
CommunityMember8bea90 Member

Lori, YOUR QUESTIONS: My youngest son (age 49) has stage 3 HS. He has been on several medications over the years and recently changed to the newest treatment (I don't yet know its name.) He says it helps him. My approach to my autoimmune and auto-inflammatory conditions are integrative since I prefer using Functional Medicine and I typically respond badly to pharmecutical drugs (they react the opposite on me than they do most people and I usually get worse rather than better on them.) 1) I am on the Autoimmune Protocol. Not sure of you are familiar with that but this means I avoid inflammatory foods, have detoxed my body, my home and my lifestyle try to avoid stress (stress is main trigger for me), rest and sleep are a huge priority for me and I take the supplements my blood labs tell me I need. For the HS this means zinc and magnesium. I am also on a natural thyroid hormone, Estrogen and Progesterone. Most of the time I am able to manage this way. If I get a bad flare I go to Urgent Care and they lance the lesion to release the pressure and then it can heal. I also use heat and a propolis drawing salve and Colloidal Silver spray and those do work for me most of the time. I also use IV infusions of high doses of Vitamin D, zinc and magnesium to give my immune system a boost. I NEVER take vaccines; flu pnumonia shots, shingle shot, COVID vaccine etc I am fortunate that I did not ever get COVID. I have worked very hard "preventatively" on my metabolic system now for 15 years as well as my immune system and this has paid off. I have recently found that the BPC 157 Peptide which is anti-inflammatory has been reducing the size of dormant boils/lesions. I am waiting to see how this Peptide works long term. 
1. Lori.Foster Community Admin
 
 Hi <inline-mention username="CommunityMember8bea90" user-id="9963403"/>. I am familiar with the Autoimmune Protocol and I know that it takes a huge committment to follow it strictly. So, I have a lot of respect for the fact that you can do that. I'm glad it's helping and that your son is finding some relief as well with his new treatment. I hope you continue to see positive results, especially with the BPC 157 Peptide. Sending lots and lots of healthy vibes your way. - Lori (Team Member)
CommunityMember8bea90 Member

I had severe endometriosis/adenomyosis and fibroids in my 20's and 30's I have often wondered if this too was connected (via the hormone imbalance) to my HS. HS runs in my family. I am the only female with it, however there are many males in y family who do suffer from it as well.
1. Lori.Foster Community Admin
 
 Hi <inline-mention username="CommunityMember8bea90" user-id="9963403"/>. Unfortunately, when you have one chronic health condition, it tends to weaken your system and open the door for others to develop. My daughter also has endometriosis. She has been diagnosed with three other chronic/autoimmune conditions so far and she's only 22 years old. She doesn't have HS disease though. I can imagine HS disease and severe endo must be a painful and exhausting combination. Do any of the males in your family have any hormonal health conditions? We don't know the cause of HS, but there is evidence that genes play a role. Hormones might possibly be one of the factors that trigger it in combination with hereditary factors. Are you on a good treatment plan for both conditions? Wishing you the best. Lori (Team Member)