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While many signs and symptoms of PCOS may not seem of immediate health concern, the condition and its associated effects can lead to significant long-term health complications.
While many signs and symptoms of PCOS may not seem of immediate health concern, the condition and its associated effects can lead to significant long-term health complications.
Explore the following to learn more about some associated long term health effects:
Explore the following to learn more about some associated long term health effects:
Diabetes Mellitus Type 2
Diabetes Mellitus Type 2
PCOS has been identified as a risk factor for developing Type 2 Diabetes Mellitus (T2DM), a chronic condition that can lead to severe complications if left untreated.
Obesity is observed in about 60% of women with PCOS¹, and it is reported that more than 20% of obese women with PCOS will have impaired glucose tolerance after the age of 30.
The central distribution of fat in obese women with PCOS is found to be associated with higher insulin concentrations¹- which can lead to an increase in insulin resistance and insensitivity overtime. This is what can cause "pre-diabetes" and eventually, T2DM.
Evidence demonstrates that the prevalence of type 2 diabetes in women diagnosed with PCOS is 7 times higher than controls (15% to 2% respectively)¹. However, the risk of developing type 2 diabetes is also increased in non-obese women with PCOS - therefore PCOS is a key independent factor inducing such long term effects¹ .
DID YOU KNOW?
Majority of women under 45 with type 2 diabetes are also diagnosed with PCOS⁴.
For more information on Type 2 Diabetes, click here
Endometrial Cancer
Endometrial Cancer
If you have fewer than three periods a year, the lining of the womb (endometrium) can thicken and this may lead to endometrial cancer in a small number of women.
Prolonged anovulation (lack of ovulation), which characterizes the syndrome, is considered to be the main mechanism responsible for continual unopposed secretion of oestrogens and consequent increased risk of endometrial carcinoma¹.
The known factors which increase the risk of developing endometrial cancer are obesity, long-term use of unopposed oestrogens, nulliparity, infertility, hypertension and diabetes.
Most of these factors are conditions/symptoms known also to be associated with PCOS.
Evidence from a big study in which 1270 women with chronic anovulation participated, the excess risk of endometrial cancer was identified¹.
ARE THE RISKS DEFINED?
Evidence from a big study on women with chronic anovulation part, an excess risk of endometrial cancer was identified - however, the true risk of endometrial carcinoma in women diagnosed with PCOS is inconclusive/unknown¹.
Studies suggest that infertility and inducing ovulation in women with PCOS can increase the risk of borderline + invasive ovarian tumors - but its direct tie to PCOS is not well researched¹.
Studies failed to show any significant increase in the risk of developing breast cancer in women with PCOS¹.
Note: a positive association between PCOS and the presence of family history of breast cancer has been found - but it is not a cause/effect relationship¹.
Cardiovascular Complications
Cardiovascular Complications
Cardiovascular disease is a factor indirectly influenced by a PCOS diagnosed. Often, its risk is heightened due to the other conditions PCOS causes¹.
More specifically, hyperinsulinemia appears to be the main reason for the increased cardiovascular risk of women with PCOS. If occurs - the pancreatic b-cell dysfunction and impaired glucose tolerance, causes an overproduction and eventual de-sensitization of insulin (as discussed under T2DM, which is what will develop here)¹.
Impaired glucose tolerance and diabetes caused by PCOS are known risk factors for cardiovascular disease¹. This is because they contribute to:
Damage to Blood Vessels - stiff + narrow arteries¹.
Unhealthy Cholesterol Levels - more "bad" lipoproteins (LDL) and triglycerides, and less "good" HDL lipoproteins¹.
Elevated plasminogen activator inhibitor-I (PAI-1) levels, which contribute to decreased¹. fibrinolysis (blood clot breakdown), and can lead to blocked arteries or coronoary heart disease ¹.
Hypertension is also a risk factor directly tied to plasma insulin levels. The prevalence of women with treated hypertension is three times higher in women with PCOS between the age of 40-59 years in comparison with controls¹. Though directly tied to PCOS, it is more related to the symptom of hyperinsulinemia that is caused by PCOS in many, like with cardiovascular disease (which is indirectly related to PCOS but directly related to a number of its potential symptoms)¹.
It is important to note, this will not be the case for all patients, and treating symptoms such as hyperinsulinemia can heavily reduce chances of long term effects¹.
Mental Health
Mental Health
Mental health is also a vital and heavily influenced factor by PCOS in the short and potential long term.
PCOS is associated with an increased risk of a diagnosis of depression, anxiety, bipolar disorder, and obsessive-compulsive disorder (OCD)². The severity of symptoms of depression, anxiety, obsessive compulsive disorder, and somatization disorders have been found higher in women with PCOS compared to those without³.
DID YOU KNOW?
Studies show that the prevalence of anxiety and depressive disorders among women with PCOS ranges from:
28% to 39% for anxiety²
11% to 25% for depression²
The hormonal imbalances characteristic of PCOS can contribute to mood disturbances, amplifying the risk of depressive symptoms and anxiety disorders. Particularly, irregular menstrual cycles, have been identified as strong predictors of mental health issues².
The hormonal imbalances characteristic of PCOS can contribute to mood disturbances, amplifying the risk of depressive symptoms and anxiety disorders. Particularly, irregular menstrual cycles, have been identified as strong predictors of mental health issues².
Social factors and stigmas surrounding increased body hair, menstrual problems, and infertility along with concerns about body image, self-esteem, and relationships are also socially relevant contributors have been tied anxiety in women with PCOS².
Social factors and stigmas surrounding increased body hair, menstrual problems, and infertility along with concerns about body image, self-esteem, and relationships are also socially relevant contributors have been tied anxiety in women with PCOS².
Recognizing and addressing these mental health implications is crucial for fostering a holistic approach to PCOS care! ²
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