If you have PCOS, you are at greater risk of developing the long-term health problems discussed below.
- Insulin resistance and diabetes
If your blood glucose does not stay normal, this can lead to diabetes. One or two in every ten women with PCOS go on to develop diabetes at some point. If the diabetes is untreated, this can cause damage to organs in the body.
If you have PCOS, your risk of developing diabetes is increased further if you:
- are over 40 years of age
- have relatives with diabetes
- developed diabetes during a pregnancy (known as gestational diabetes)
- are obese (a body mass index (BMI) of over 30).
If you are diagnosed with diabetes, you will be given advice about your diet and may be prescribed tablets or insulin injections.
High blood pressure
Women with PCOS tend to have high blood pressure, which is likely to be related to insulin resistance and to being overweight rather than to the PCOS itself. High blood pressure can lead to heart problems and stroke, hence the early diagnosis and treatment is essential.
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.
There are various ways to protect the lining of the womb using the hormone progestogen and these can be discussed with your gynaecologist. These may include the following:
- A five-day course of progestogen tablets used every three or four months
- Contraceptive pill
- Intrauterine contraceptive system (Mirena). The options will depend on whether you are trying for a baby. It is worth mentioning that PCOS does not increase your chance of breast or ovarian cancer.
Depression and mood swings
The symptoms of PCOS may affect how you see yourself and how you think others see you. It can lower your self-esteem.
Sleep apnoea
Sleep apnea is a condition in which breathing stops (apnoea) during sleep for short periods of time. Women often experience fatigue and drowsiness during the day. There is evidence to suggest that sleep apnoea, without treatment, increases the risk of insulin resistance, obesity, diabetes, and cardiovascular problems (high blood pressure, heart attack, arrhythmias) and stroke. This risk is related to the variation of heart rate and blood pressure during sleep.
What can you do to reduce long-term health risks?
Have a healthy lifestyle
The main ways to reduce your overall risk of long-term health problems are to eat a healthy balanced diet. This should include fruit and vegetables and whole foods (such as wholemeal bread, whole-grain cereals, brown rice and whole-wheat pasta), lean meat, fish and chicken.
You should also follow the advice below:
- Reduce the amount of sugar, salt and caffeine that you eat and drink.
- Reduce alcohol consumption (14 units a week for women).
- Eat meals regularly, especially breakfast
- Take exercise regularly (30 minutes at least three times a week)
- Aim to keep your weight within normal levels
Body mass index (BMI) is the measurement of weight in relation to height and you should aim to keep your BMI between 19 and 25. If you are overweight, it would be helpful to lose weight and maintain your weight at this new level. If your BMI is more than 30, you may discuss ways of losing weight, including weight-reducing drugs, with your dietician and endocrinologist.
The benefits of losing weight include:
- a lower risk of insulin resistance and developing diabetes
- a lower risk of heart problems
- a lower risk of cancer of the womb
- more regular periods
- an increased chance of becoming pregnant
- a reduction in acne and a decrease in excess hair growth over time
- improved mood and self-esteem.
You only have to lose a small amount of weight to make a difference to your symptoms and your health. There is no strong evidence to suggest that PCOS by itself can cause you to gain weight or makes losing weight difficult.
Have regular health checks
Once you have a diagnosis of PCOS, you will be monitored to check for any early signs of health problems:
Diabetes: Women with PCOS over the age of 40 should be offered a blood sugar test once a year to check for signs of diabetes. If your BMI is 30 or over or you have a family history of diabetes, you may be offered testing for diabetes earlier than age 40.
Cancer of the womb: If you have not had a period for a long time (over 4 months) or have irregular bleeding, it is advisable to see your doctor. You may be offered a referral for further tests that may include an ultrasound scan of your womb (uterus) or treatment to make you have a period if they are very irregular.
High blood pressure: Discuss with your doctor how often you should have your blood pressure checked and whether you should have blood tests to check your cholesterol levels.
Depression and psychological problems: You can be referred to a psychologist if necessary.
