Why drinking too much coffee can cause PCOS

Coffee has become one of the most common beverages worldwide. Although coffee contains disease-fighting antioxidants and anti-inflammatory substances and helps to elevate mood, its excessive intake can contribute to developing Polycystic Ovary Syndrome (PCOS)—a hormonal disorder seen among women of child-bearing age. Dr Surabhi Siddhartha, Consultant Obstetrician and Gynaecolog, Motherhood Hospital, Kharghar, shares her view.
Can excessive coffee consumption lead to the risk of polycystic ovary syndrome (PCOS)?
The caffeine content in coffee reduces insulin sensitivity and raises blood glucose level, which is bad for PCOS. It is a well-known fact that caffeine is one of the ingredients which affects the central nervous system and metabolic systems of the body.
Various studies published in medical websites like Lancet have found a correlation between habitual coffee drinkers and secondary infertility. Caffeine impacts reproductive health affecting endogenous hormone levels through change in ovarian function or alterations in hormone metabolism.
Within the body, caffeine acts as a non-selective adenosine antagon. It increases the intracellular concentration of Cyclic adenosine monophosphate (AMP) — that regulates glycogen, sugar, and lipid metabolism — and alters the blood vessels of catecholamines.

Besides caffeine, coffee contains numerous other bioactive substances, including lignans and isoflavones, which are phytoestrogens and have great affinity towards estrogen receptors. As both caffeine and estrogen are metabolised the liver, there is a possibility that these bioactive substances of coffee might also interfere with estradiol levels through common metabolic pathways. Thus, these changes in hormonal levels might impact a woman’s menstruation cycle.
It is also noted that coffee intake has been associated with decreased levels of estrogen and hCG during pregnancy. In fact, coffee consumption elevates catecholamines that combine dopamine, adrenaline, and noradrenaline which might impact placental blood flow. Caffeine also increases the stress hormone cortisol, which raises insulin suppressing progesterone (a female hormone that impacts menstrual cycle, pregnancy, and embryogenesis) production.

Considering these and all other studies, European food safety authority and WHO recommends that consumption of caffeine be limited below 200mg³ per day for women desiring to conceive and pregnant women.
What if I am a frequent drinker? How can I wean off the habit?
If consumed in a limited amount, coffee can contribute to weight loss. If you have a craving, then try replacing your daily intake of coffee with green tea which has a tenth of the caffeine of a cup of coffee. Also, it is alkaline which doesn’t purge valuable nutrients like coffee.
Coffee helps in prevention of age-related cognitive decline and Alzheimer’s, improves productivity at work decreasing fatigue, elevates mood and inculcates a feeling of well-being among others. But the highlight is it should be consumed in moderate amounts daily.