Health Risks Associated with PCOS

Many women don't realize they have PCOS until they see a doctor to determine why they cannot get pregnant. Infertility or subfertility (reduced fertility) is a common problem for women with PCOS.

This may be due to the imbalance of hormones caused by an overproduction of the male hormone testosterone. The ovaries may infrequently release ova (eggs).

Thanks to the availability of ovulation-inducing drugs and advances in assisted reproductive technologies, many women with PCOS can now conceive.

Although PCOS may reduce a woman's chances to become pregnant, the disease is not a substitute for birth control. Many women with PCOS do become pregnant, without medical assistance. Women who are sexually active and do not wish to conceive should consider using a contraceptive.

Women with PCOS appear to be at increased risk for developing cancer of the endometrium (lining of the uterus) later in life.

From your teens through menopause, all women experience a monthly buildup of the endometrial lining in the uterus, as the body prepares itself for the potential of a fertilized egg. If you do not become pregnant, the lining normally is shed through menstruation.

Women with PCOS also experience the monthly buildup of the endometrial lining. However, the lining is not sufficiently shed because she has infrequent or nonexistent menstrual periods. Thus, the lining continues to build and can increase the risk of endometrial cancer.

Insulin helps the body to metabolize or process glucose (blood sugar). Insulin resistance or impaired glucose tolerance have been linked to PCOS. Furthermore, high levels of insulin stimulate the production of testosterone, which aggravates PCOS.

By age 40, up to 40 percent of women with PCOS have some level of abnormal glucose tolerance, in the form of either diabetes or impaired glucose tolerance.

Our physicians at UChicago Medicine's Center for Polycystic Ovary Syndrome conduct ongoing research on the role of insulin resistance and insulin action in women with PCOS. Much of this research has been published in medical journals, such as New England Journal of Medicine and Journal of Clinical Endocrinology and Metabolism.

Hyperandrogenism (increased testosterone) can lead to an unfavorable lipid profile in women with PCOS. This means that a woman with PCOS may have an unfavorably high level of fat substances in her bloodstream. In some women, the blood lipid profile may show a lower rate of high-density lipoproteins (HDL, the "good" cholesterol) and a higher rate of low-density lipoproteins (LDL, the "bad" cholesterol). This imbalance increases the risk for cardiovascular disease.

Evidence suggests that women with PCOS are at increased risk for heart disease and other cardiovascular diseases.

In addition, the tendency for women with PCOS to be overweight increases the risk of cardiovascular disease, just as obesity increases cardiovascular risk among women and men who do not have PCOS.

Studies conducted at the University of Chicago have confirmed the exceptionally high risk of obstructive sleep apnea among women with PCOS. While it is clear that increased body weight contributes to this risk, women with PCOS seem to be at high risk as a consequence of other factors in addition to weight. For example, the high testosterone levels in PCOS also seem to play a role in the development of sleep apnea.

Dr. David A. Ehrmann and his colleagues are conducting studies to determine if treatment of obstructive sleep apnea reduces the severity of metabolic abnormalities in PCOS. Studies are also being carried out to determine if treatment of PCOS reduces the severity of sleep apnea.