Polycystic ovary syndrome (PCOS) is one of the most common endocrines disorders among women of reproductive age and is thought to affect approximately 4-12% of these women.
Although PCOS may affect any premenopausal woman, it is most commonly diagnosed before the age of 16, close to the age of menarche or the first menstrual period. However, the diagnosis may occur later if the patient does not seek medical advice about subtle symptoms, such as irregular menstruation and excessive hair growth.
Women with PCOS are more likely to be affected by some other health conditions, such as cardiovascular and endometrial diseases. This risk is amplified in women who are overweight or obese. The prognosis of these associated complications is discussed in more detail below.
The extent of hirsutism, a common symptom of PCOS involving excessive hair growth, varies greatly according to the ethnicity of the woman. For example, women of Asian ethnicity are less likely to be affected than Caucasian women, even if the serum androgen levels are comparable. PCOS is the most common cause of hirsutism and may affect up to 10% of women.
Approximately 4 in 10 women with PCOS have some extent of resistance to insulin and are at risk of developing type 2 diabetes mellitus. Additionally, more than half of all women with PCOS develop diabetes or impaired glucose tolerance before they reach the age of 40.
It is recommended that all women with PCOS be screened for conditions such as diabetes at the age of 30 years, regardless of body weight. Some women under this age may also need screening tests, particularly if they are at high risk of diabetes due to large body weight. It is important that these screening tests are repeated at regular intervals to ensure that treatment can be initiated earlier if the condition develops at a later point.
Women with PCOS have a higher risk of heart disease and are 4 to 7 times more likely to have a heart attack than women without the condition who are of the same age.
This is most likely linked to other cardiovascular factors that increase the risk of cardiovascular disease and myocardial infarction. For example, women with PCOS are more likely to have hypertension and hypercholesterolemia.
Women affected by PCOS are also at risk of endometrial hyperplasia and endometrial cancer. In fact, women with PCOS have a lifetime risk of developing endometrial cancer of 9%, which is three times higher than other women whose risk is only about 3%.
This association is due to the extended time without ovulating, which continuously stimulates the growth of the endometrial lining, due to the presence of estrogen hormone without progesterone. However, the outcomes of developing endometrial cancer may be improved with appropriate treatment and screening methods.
Prevention of Complications
It is possible to improve the prognosis for women with PCOS by managing the symptoms of the condition in the best way. Encouraging a healthy lifestyle is important, with a particular emphasis on healthy diet and lifestyle to maintain a normal weight.
Reviewed by Susha Cheriyedath, MSc