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Significant long-term health effects may result from polycystic ovary syndrome (PCOS), including diabetes, cardiovascular disease, endometrial cancer, and breast cancer. Reduction of each of these risks must be part of the overall management plan for women with PCOS.

Endometrial Cancer and Breast Cancer

Because of the exposure of the endometrium to prolonged, high estrogen levels in women with PCOS, the risk of endometrial hyperplasia is elevated. To reduce this risk, it is important for a woman to have a regular menstrual bleed once a month during which time the outer layer of the endometrium is shed. Some physicians are of the opinion that a menstrual cycle at least once every three months is acceptable for a woman with PCOS.

For most women with PCOS, regular menstrual cycles can be achieved through:

• Weight loss
• Exercise
• Oral contraceptive pills

• Progestogen-containing medications only:

  • Medroxyprogesterone acetate (e.g., Provera)
  • Micronized progesterone (e.g., Prometrium)
  • Crimone vaginal gel

It is also important for women with PCOS to be followed by a gynecologist into their menopausal years since they may have experienced the exposure to prolonged elevated estrogen in the past.

Type II Diabetes

The risk of Type II diabetes in woman with PCOS can be reduced by:

• Careful diet
• Regular exercise
• Weight loss
• Insulin-sensitizing medication (e.g., metformin) which may delay or prevent onset of diabetes

According to the Diabetes Prevention Program of the National Institute of Diabetes and Digestive and Kidney Diseases, women with impaired glucose tolerance can significantly reduce their risk of developing diabetes by appropriate lifestyle changes and by taking metformin if necessary.

Cardiovascular Disease

To minimize cardiovascular risk, it is very important for patients with PCOS to take steps to control factors such as:

• Cholesterol (LDL, HDL)
• Triglycerides
• Dyslipidemia
• Hypertension

This can usually be achieved through:

• Careful diet
• Regular exercise
• Weight loss
• If necessary, medication to help control cholesterol and hypertension