Polycystic Ovary Syndrome (PCOS)

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 5-15% of women in the reproductive age. It is characterised by chronic anovulation, hyperandrogenism and polycystic ovaries.

PCOS is a complex condition that may require management by a multidisciplinary team. Despite the fact that no cure is available for this condition, good control of the symptoms can be achieved with lifestyle and dietary modifications. PCOS should be diagnosed early to promote long-term health and prevent metabolic and cardiovascular complications.

What are the long-term risks associated with polycystic ovary syndrome (PCOS)?

• Weight gain/obesity
• Insulin resistance and type 2 diabetes (T2DM)
  Adolescents and adult women with PCOS are at increased risk for impaired glucose tolerance (IGT) and T2DM. A diagnosis of PCOS confers a 5- to10-fold increased risk of developing T2DM. The use of an oral glucose tolerance test - OGTT (consisting of a fasting and a 2-hour glucose level using a 75 g oral glucose load) is recommended to screen for IGT and T2DM.
  
• Cardiovascular disease
  Women with PCOS should be screened for the following cardiovascular disease risk factors: family history of early cardiovascular disease, cigarette smoking, IGT/ T2DM, hypertension, dyslipidaemia, obstructive sleep apnoea, and obesity (especially increased abdominal fatty tissue).
  
• Endometrial cancer
  Women with PCOS have a threefold increased risk of developing an endometrial cancer (cancer of the inner lining of the uterus). There is currently no data supporting routine endometrial biopsy of asymptomatic women or ultrasound screening of the endometrium. However, women should be counselled to report unexpected bleeding and spotting.
  
• Depression and mood swings
  Women with PCOS should be screened for depression and anxiety by history and, if identified, appropriate referral and/or treatment provided.