PCOS Health Risks
If you have been diagnosed with PCOS, it is important to understand the long-term health risks associated with the disease. Not all women with PCOS will develop all of these conditions, but having PCOS does increase your risk. It is important to have your health monitored regularly by a physician who has experience treating women with PCOS. Regularly scheduled physician visits should continue after menopause, even though you will no longer have erratic periods and other PCOS symptoms may lessen.
Infertility or Subfertility
Many women don't realize they have PCOS until they see a doctor to determine why they cannot get pregnant. Infertility or subfertility (reduced fertility) is a common problem for women with PCOS.
This may be due to the imbalance of hormones (including the ovaries' overproduction of the "male" hormone: testosterone). The ovaries may release ova (eggs) only infrequently.
Thanks to the availability of ovulation-inducing drugs and advances in assisted reproductive technologies, many women with PCOS can be helped to conceive.
Although PCOS may reduce a woman's chances to become pregnant, the disease is not a substitute for birth control. Many women with PCOS do become pregnant, without medical assistance. Women who are sexually active and do not wish to conceive should consider using a contraceptive.
Endometrial Cancer (Endometrial Carcinoma)
Women with PCOS appear to be at increased risk for developing cancer of the endometrium (lining of the uterus) later in life.
From her teens through menopause, all women experience a monthly buildup of the endometrial lining in the uterus, as the body prepares itself for the potential of a fertilized egg. If a woman does not become pregnant, the lining normally is shed through menstruation.
Women with PCOS also experience the monthly buildup of the endometrial lining. However, the lining is not sufficiently shed because she has infrequent or nonexistent menstrual periods. Thus, the lining continues to build and can increase the risk of endometrial cancer.
Insulin helps the body to metabolize or process glucose (blood sugar). Insulin resistance or impaired glucose tolerance have been linked to PCOS. Furthermore, high levels of insulin stimulate the production of testosterone, which aggravates the PCOS.
By age 40, up to 40 percent of women with PCOS have some level of abnormal glucose tolerance, in the form of either diabetes or impaired glucose tolerance.
David A. Ehrmann, MD, and other physicians at the University of Chicago Medicine Center for PCOS conduct ongoing research on the role of insulin resistance and insulin action in women with PCOS. Much of this research has been published in medical journals such as New England Journal of Medicine and Journal of Clinical Endocrinology and Metabolism.
Hyperandrogenism (increased testosterone) can lead to an unfavorable lipid profile in women with PCOS. This means that a woman with PCOS may have an unfavorably high level of fat substances in her bloodstream. In some women, the blood lipid profile may show a lower rate of high-density lipoproteins (HDL, the "good" cholesterol) and a higher rate of low-density lipoproteins (LDL, the "bad" cholesterol). This imbalance increases the risk for cardiovascular disease.
Evidence suggests that women with PCOS are at increased risk for heart disease and other cardiovascular diseases.
In addition, the tendency for women with PCOS to be overweight increases the risk of cardiovascular disease, just as obesity increases cardiovascular risk among women and men who do not have PCOS.
Obstructive Sleep Apnea
Studies conducted at the University of Chicago have confirmed the exceptionally high risk of obstructive sleep apnea among women with PCOS. While it is clear that increased body weight contributes to this risk, women with PCOS seem to be at high risk as a consequence of other factors in addition to weight. For example, the high testosterone levels in PCOS also seem to play a role in the development of sleep apnea.
Dr. Ehrmann and his colleagues are conducting studies to determine if treatment of obstructive sleep apnea reduces the severity of metabolic abnormalities in PCOS. Studies are also being carried out to determine if treatment of PCOS reduces the severity of sleep apnea.