Polycystic Ovarian Syndrome: Long-Term Health Consequences

Abstract

Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy in women and can be associated with significant adverse sequelae that can affect overall long-term health and well-being. This review provides a succinct but comprehensive overview of our current understanding concerning the known morbidities of PCOS, beginning with a review of the importance of the different phenotypes of PCOS in determining long-term morbidity, the confounding impact of obesity on health outcomes in PCOS, and the immediate short-term consequences of the disorder (including dermatologic, reproductive, and mood disturbances). The longer-term morbidities of PCOS are then reviewed including metabolic consequences (impaired glucose tolerance and type 2 diabetes mellitus, metabolic syndrome, and nonalcoholic fatty liver disease), dyslipidemia and vascular dysfunction (including hypertension and increased incidences of cerebrovascular accidents and thromboembolisms on oral contraceptives), neoplastic (primarily endometrial adenocarcinoma), and mental health disorders (including greater incidences of depressive and anxiety disturbances and psychosexual dysfunction). In conclusion, strategies for the prevention and amelioration of long-term morbidities in PCOS are presented.

Association between polycystic ovary syndrome and the vaginal microbiome: A case‐control study

“…The syndrome is a serious public health problem, with long‐term health consequences. Apart from the usual clinical symptoms (menstrual disorders, hirsutism, infertility and obesity), women with PCOS have long‐term metabolic consequences (ie impaired glucose tolerance, type 2 diabetes mellitus, metabolic syndrome and nonalcoholic fatty liver disease 2 ). The disease aetiology is still unclear; however, some hypotheses include hypothalamic‐pituitary‐ovary axis dysfunction, androgen excess 3 and insulin resistance and glucagon 4 .…”

Relationship between glucose homeostatic disorders and testosterone in adult Nigerian women with polycystic ovary syndrome

“…Insulin resistance is adjudged a well-recognized associated metabolic factor with various implications in the pathophysiology of PCOS. 9 As a consequence of the insulin resistant state inherent in PCOS, numerous studies had documented the increased prevalence of glucose homeostatic disorders among women with PCOS compared to normal control population. 10 Androgen excess, associated with the syndrome, is hypothesized to influence glucose homeostasis in patients with PCOS.…”

Why we need epidemiologic studies of polycystic ovary syndrome in Africa

“…1 Typically, the syndrome is characterized by chronic oligo-anovulation, biochemical and/or clinical hyperandrogenism, and polycystic ovarian morphology (PCOM). 1,2 As a syndrome, PCOS is defined by a collection of signs and symptoms after the exclusion of related or mimicking disorders. 2 Women with PCOS seem to be more frequently obese than their non-affected counterparts, although the degree of this association is weak when medically unbiased populations are studied.…”

“…In addition to hyperandrogenic dermatologic symptoms (acne, alopecia, and hirsutism), PCOS is associated with impaired reproduction and obstetric outcomes. 2 Women with PCOS seem to be more frequently obese than their non-affected counterparts, although the degree of this association is weak when medically unbiased populations are studied. 3,4 PCOS is also associated with an increased risk of endometrial and possibly ovarian carcinoma.…”

“…Lastly, most women with PCOS, regardless of body mass, have variable degrees of chronic subacute inflammation and insulin resistance, which are associated with an increased risk of type 2 diabetes mellitus, dyslipidemia, and vascular disorders including cerebrovascular incidents and possibly even cardiovascular disease. 1,2 As a syndrome, PCOS is defined by a collection of signs and symptoms after the exclusion of related or mimicking disorders. In 1990, the relatively strict US National Institutes of Health (NIH) criterion categorized two phenotypes of PCOS: phenotype A, comprising oligo-anovulation, hyperandrogenism, and PCOM; and phenotype B, comprising oligo-anovulation and hyperandrogenism.…”