PCOS-related health conditions

What are the health conditions related to PCOS?

Besides insulin resistance and the high levels of androgens (also known as male-type hormones) other health issues associated with PCOS are:

• prediabetes & type 2 diabetes
• cardiovascular disease
• metabolic syndrome (generally having at least two of high blood pressure, high cholesterol, obesity, high fasting blood glucose)
• endometrial cancer
• sleep apnoea
• pregnancy complications
• gestational diabetes.

Prediabetes & type 2 diabetes

Women with PCOS have between a four and seven times increased risk of developing prediabetes and type 2 diabetes than women without PCOS.^[1]

Prediabetes is the stage before type 2 diabetes. Women with PCOS are also more likely to develop diabetes earlier, for example, in their 30s and 40s. This risk is further increased by:

• being overweight or obese
• having insulin resistance
• having an immediate family member with type 2 diabetes.

Discuss with your doctor the ways you can help to reduce the risk of developing diabetes through a healthy lifestyle.

Women with PCOS have a higher risk of developing diabetes in pregnancy (gestational diabetes). This risk increases if you are overweight when pregnant.

Cardiovascular risk factors

Women with PCOS have increased cardiovascular risk factors.^[1] These risk factors can increase your chance of developing cardiovascular disease. Cardiovascular disease is the term used for heart, stroke and blood vessel diseases.

Factors include:

• high blood fats or cholesterol
• high levels of 'bad' cholesterol or low-density lipoprotein cholesterol, which increases the risk of developing heart disease
• high levels of inflammatory proteins, which can alter the function of blood vessels and increase insulin resistance
• high blood pressure.

Being overweight can increase these risks, but these risks appear to be increased in PCOS independent of the effect of obesity.

These risk factors can be reduced significantly by a healthy lifestyle – plenty of physical activity and a nutritious and healthy diet – and the prevention of weight gain, or management of excess weight.

Metabolic syndrome

Women with PCOS have a higher prevalence of ‘metabolic syndrome’.^[2] Metabolic syndrome is a collection of conditions (listed below) that often occur together and increase the risk of type 2 diabetes and cardiovascular disease:

• impaired glucose tolerance (indicating the beginnings of insulin resistance)
• high blood pressure
• abdominal obesity
• high blood cholesterol.

Endometrial cancer

Having the condition PCOS does not cause endometrial cancer; instead, it is having very infrequent periods that might increase the risk of endometrial cancer.

Regular periods help to prevent excess thickening of the lining of the uterus (womb). Not having regular periods can lead to abnormal cells building up inside the womb. It is important you have at least four cycles a year to avoid a build-up that might include abnormal cells. The oral contraceptive pill can be used to improve the regularity of periods. If you have fewer than four periods a year, discuss this with your doctor.

Adequate physical activity and having a healthy body weight can also assist in making periods regular.

Sleep apnoea

Women with PCOS, particularly when they are overweight or insulin resistant, can be at an increased risk of developing sleep-disordered breathing, or sleep apnoea. Sleep apnoea occurs when the upper airway is obstructed during sleep. Excessive fatty tissue in the neck can partially block the airway, leading to altered breathing patterns during sleep. This leads to sleep loss, fatigue, tiredness and reduced quality of life.

Treatments are available to assist with sleep apnoea. Speak to your doctor if you are concerned this might be affecting you.

Pregnancy complications

Once a woman with PCOS becomes pregnant, there can be some increased risks of developing some health conditions during pregnancy. These can include:

• miscarriage
• ectopic pregnancy
• gestational diabetes (see below)
• gestational hypertension (high blood pressure)
• pre-eclampsia (the typical signs of this are high blood pressure and high levels of protein in the mother’s urine; it can be dangerous to both the mother and the unborn baby)
• pre-term (early) birth
• effects on the baby’s size: the baby might be either small or large for its gestational age.

If you have PCOS it is important to tell your pregnancy health-care professional. They will need to monitor and manage these conditions, should they occur.

Gestational diabetes

Gestational diabetes (diabetes during pregnancy) is a common condition where there is too much glucose in the blood.

Women with PCOS have a higher risk of developing gestational diabetes during pregnancy because of insulin resistance. This risk increases if you are overweight when pregnant.

Women usually recover from gestational diabetes after their baby is born, when their blood glucose levels return to normal. However, they remain at a higher risk of developing type 2 diabetes after pregnancy, so monitoring and prevention are very important.

To reduce your risk, it is important to maintain a healthy weight, remain as physically active as possible and eat a healthy and nutritious diet during pregnancy.

What you can do

If you are worried about the risks of health conditions related to PCOS, it is helpful to:

• Get your symptoms of PCOS under control as a first step
• Learn about and understand your risks
• Have your blood pressure, blood glucose and cholesterol checked regularly
• Seek guidance and support to help with weight management, if needed
• Discuss any of your concerns with your doctor

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at September 2019.