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Women with polycystic ovary syndrome (PCOS) have an increased risk of developing several complications. These include:

Type II Diabetes Mellitus

Women with PCOS are 3-6 times more likely to develop Type II diabetes in middle age than women in the general population. Studies indicated that in PCOS patients over the age of 30, 12% had diabetes compared to 1.5% of the control group (women without PCOS). In the long term, diabetes is a major cause of morbidity for women with PCOS.

It is estimated that 25-40% of obese women with PCOS develop Type II diabetes or impaired glucose tolerance by the age of 30 and 60% of obese women with PCOS develop type II diabetes by the age of 50.

Cardiovascular Disease

• Dyslipidemia , a condition of abnormally high concentrations of lipids or lipoproteins in the blood, such as LDL (low-density lipoproteins), HDL (high-density lipoproteins), and triglycerides may also be found in women with PCOS and is a risk factor for cardiovascular disease. Dyslipidemia is associated with insulin resistance.

• Hypertension - there is ongoing discussion regarding whether women with PCOS (particularly obese women) may have a higher risk for developing hypertension, which increases the risk for cardiovascular disease.

Cardiovascular disease is thought to appear earlier in women with PCOS than in the general population. Because of the high risk for cardiovascular disease, the American College of Obstetrics and Gynecology (ACOG) recommends that all women diagnosed with PCOS be screened for:

• Dyslipidemia - factors to be to be evaluated include:

  • total cholesterol
  • LDL (low density lipoproteins)
  • HDL (high density lipoproteins)
  • triglycerides

• Calculation of body mass index (BMI)

• Calculation of waist:hip ratio

Metabolic Syndrome

Studies have shown that women with PCOS are at an elevated risk for developing metabolic syndrome, which refers to a group of conditions that appear together and can be a source of morbidity and mortality. These include:

• Type II diabetes
• Increased blood glucose after fasting (i.e. not related to food intake) to a level greater than 110 mg/dl
• Increased waist circumference (greater than 35 inches)

• Cardiovascular disease

  • dyslipidemia - including low HDL, (less than 50 mg/dl) and high triglycerides (greater than 150 mg/dl)
  • hypertension (blood pressure greater than 130/85 mm Hg)

Endometrial Hyperplasia and Breast Cancer

The hormonal imbalance caused by PCOS results in prolonged elevated levels of estrogen. Prolonged exposure to elevated estrogen levels results in increased risk for developing endometrial hyperplasia and breast cancer.

• Endometrial hyperplasia (thickening of the endometrial lining) which is a precancerous condition that increases the risk for developing endometrial cancer.

In the course of the normal menstrual cycle, if there is no conception, the level of estrogen falls causing the endometrium to slough off its lining in a menstrual flow. This process is crucial for the health of the endometrium but is missing in some women with PCOS.

• Some studies have shown that long-term exposure to estrogen raises a woman's risk of developing breast cancer.

Due to the increased risk of these significant conditions, it is important for women with PCOS to be followed regularly by a health professional even into menopausal years. Yearly visits may include tests for blood sugar, insulin, cholesterol, triglycerides as well as gynecological checkups.