PCOS is a complex disorder that can impact many organ systems in a woman. However, the focus of management for the polycystic ovarian syndrome (PCOS) has long been mostly on the menstrual cycle and a woman’s fertility. If PCOS is not well managed, it can lead to serious long-term complications. PCOS should be considered not just as a reproductive age disorder but as a long-life syndrome. Long-term effects of PCOS can be managed by health and lifestyle changes along with necessary medical treatment at the Chennai PCOS clinic. Knowledge and insight on the short and long-term complications of PCOS can change our perspective on women’s health and longevity. Complications of PCOS include:
Early complications of PCOS
- Infertility is not only one of the main symptoms but also a significant complication attributed to PCOS. Evidence suggests that PCOS is the most common cause of the ovulatory disorder and oligo anovulation leading to an increased risk for infertility. Primary infertility was reported in 50% of women, while secondary infertility was reported in 25% of women involved in a study conducted on 1741 women. PCOS comorbidities like insulin resistance and obesity are independently related to an increased risk of abortion, reduced pregnancy, and low live-birth rates. Endometrial abnormalities affecting the implantation can also potentially contribute to infertility in women with PCOS. Ovarian alterations at several levels can subsequently impact oocyte competence and quality. However, typical effects of infertility appeared to diminish with increasing age in women with PCOS. In fact, it has also been demonstrated that the reproductive outcome of women with a previous diagnosis of PCOS can become similar to that of non-PCOS women.
- Pregnancy-induced hypertension and preeclampsia have been reported as complications of pregnancy with threefold increased risk in women with untreated PCOS. Data, thus obtained from retrospective studies, have been confirmed by a prospective study, demonstrating the risk of pregnancy-induced hypertension and preeclampsia at the rate of 12.7% and 8%, respectively, and significantly higher as against the rate of occurrence in healthy women as 5.3% and 2%, respectively.
- Gestational diabetes mellitus (GDM) is the most commonly described pregnancy complication in women with PCO. The absolute risk is expected to be 6%–15% whereas studies have confirmed an increased incidence of GDM of up to 14.7% and 22% in women with PCOS.
- Premature birth with twofold increased risk for neonatal intensive care and threefold increased risk of neonatal mortality is reported in women with PCOS. This is attributed to the twofold increased risk of preterm delivery in women with PCOS. There is data on the risk of increased caesarean section and adverse foetal outcomes in women with PCOS. The obstetric risk may be exacerbated by comorbidities, such as obesity and insulin resistance in PCOS.
Late complications of PCOS
- Diabetes as a result of insulin resistance is a frequent complication where the body becomes resistant to using glucose properly leading to higher glucose levels and increased production of insulin. Consistent high levels of glucose in the blood over a long period can lead to diabetes. It has been reported in a study published in 2012 that 39.3% of women with PCOS developed type 2 diabetes as compared to only 5.8% of women without PCOS.
- Cardiovascular risk has an increased prevalence in women with PCOS. Dyslipidaemia is very common in women with PCOS. CVD risk factors are also related to the systemic inflammatory state in PCOS. High insulin levels associated with PCOS are known to increase the risk of conditions like high triglycerides, inflammatory markers, blood pressure, and atherosclerosis that can, in the long run, increase the risk for heart attack and stroke. Moreover, women with hyperandrogenic PCOS have a worse cardiometabolic profile and higher prevalence of CVD risk factors compared with women with non-hyperandrogenic PCOS.
- Endometrial cancer is more common in women with more irregular and fewer periods as in PCOS. In PCOS, the endometrial lining may not be shed, constantly exposing too many high amounts of oestrogen making the endometrium grow much thicker than normal, thus increasing the chance of initiating cancer cells to grow. Restoring hormone balance and menstrual regularity is an important part of PCOS management through medication, healthy diet, exercise, and weight loss. Establishing regular menstrual cycles is a significant part of PCOS and endometriosis treatment in Chennai. Oncology risk may also be associated with an increased risk of the development of cancers, such as ovarian and breast cancer, which recognize potential hormonal and/or metabolic pathogenetic mechanisms.
- A metabolic syndrome is a group of risk factors commonly presented together, increasing the risk of cardiovascular disease in women with PCOS. Metabolic changes associated with this syndrome include increased abdominal weight, high levels of triglycerides, low levels of good cholesterol, high blood pressure, and high fasting blood sugar. One in three women with PCOS has the chance of developing metabolic syndrome due to the interlinks with obesity and insulin resistance. Though some women diagnosed with PCOS may not be obese, they are more likely to have upper body fat due to the android fat distribution that represents the most metabolic-relevant adipose tissue. In fact, excess weight and abdominal circumference are the greatest health implications associated with PCOS.
- Psychological disorders in PCOS present with an increased risk of reduced quality of life. A systematic review of study literature showed an increased prevalence of generalized anxiety and an increase in mean anxiety scores in women with PCOS compared with healthy women. Prevalence of psychological disorders could be due to the PCOS itself or its features, such as obesity, hirsutism, acne, irregular periods, and infertility. However, despite several biases based on the heterogeneous nature of PCOS and the prevalence of multiple factors changing across the life span, it is difficult to establish the proportion of women with PCOS falling into the psychological risk group.
PCOS has to be considered and treated as a lifelong multisystemic and multifaceted disorder, the reproductive and metabolic complications characterizing the condition. PCOS clinic near me recommends PCOS management to be continuous and holistic towards long-term health and wellness.