The Effects of PCOS on your Long-Term Health

While I'm at home practicing social/physical distancing, I thought it would be an opportune time to catch up on the literal stack of studies I've printed out over the last year or two - many of them being about PCOS (polycystic ovary syndrome).

Today I'm going to summarize an article that came out in 2018, which discusses the effects of PCOS on your long-term health.

A quick recap: PCOS is the most common hormonal disorder in reproductive-aged women. To be diagnosed, you need at least 2 of the 3 following criteria:

1. Delayed ovulation or irregular menstrual cycles (oligomenorrhea)
2. High androgenic hormones like testosterone
3. Polycystic ovaries on ultrasound

If you're in the perimenopausal and menopausal time period, you can still be diagnosed with PCOS if you've experienced a history of irregular periods and high male hormone levels (which may have resulted in male-pattern hair growth or hair loss) in your reproductive years.

Because PCOS is associated with many other conditions like diabetes and metabolic syndrome, the study suggests that we should also be spending time decreasing the risk of future symptoms in addition to treating the symptoms you may be currently experiencing.

Type 2 Diabetes and PCOS

Women with PCOS often have a higher risk of developing impaired glucose tolerance - which essentially means that your body isn't able to process glucose (aka. sugar) as effectively as it should, thereby leading to higher blood sugar levels.

This finding was seen in women who's PCOS was diagnosed based on total testosterone levels and a history of irregular menstrual cycles.

In women over the age of 40, those with a 'normal' weight still had increased odds of developing diabetes, compared to 'normal' weight women without PCOS.

Overall during the reproductive years, the risk of impaired glucose tolerance is increased. Whereas the risk of diabetes is increased during perimenopause and menopause. This means that if you've been diagnosed with PCOS, you should be monitoring your fasting blood glucose and fasting insulin every 1-3 years to assess your risk of eventually developing diabetes.

Dyslipidemia and PCOS

Dyslipidemia is a fancy word for abnormal amount of lipids (fats) in your blood. In people with PCOS, this is seen in those who are overweight/obese, and may happen when they're younger and can persist past menopause. So, this would likely also result in screening every couple of years to assess risk.

Overweight, Obesity and PCOS

Obesity is super common in women with PCOS, and they often express their difficulties in losing weight. Most evidence demonstrates that women with PCOS continue to be overweight/obese as they age compared to women without PCOS. Specifically, obesity is higher in white women compared to Asian women.

Metabolic Syndrome and PCOS

Metabolic syndrome is a collection of five health conditions:

• Insulin resistance
• High blood pressure
• High fatty acids in your blood
• Low HDL cholesterol (aka. the 'good' cholesterol)
• Visceral obesity (aka. a waist circumference of more than 35 inches in women)

Because PCOS can encompass many of these conditions, it's worth it for us to pay attention to these conditions from a preventative mindset and screen frequently.

Pregnancy Complications and PCOS

Check out a post I wrote about how PCOS can affect your pregnancy. I cover miscarriage, gestational diabetes, pregnancy-induced hypertension, and more.

Depression, Anxiety, and PCOS

Although there isn't any great research looking at depression and anxiety in PCOS women over 40 years old, there is an increased incidence of depression and anxiety in younger women with PCOS.

Final Thoughts

If you have PCOS, it's important to address your condition now, but to also think of things preventatively. Because insulin resistance and diabetes is so prominent - you may want to discuss the benefit of annual blood work to assess your risk. These two conditions can also lead to obesity and metabolic syndrome, making it exceptionally important to be aware of.

If you're pregnant, please check out my pregnancy and PCOS blog post to get an idea of what you should be aware of as you approach the second and third trimester.

Blood tests you should *also* be looking at yearly:

• Fasting insulin
• Fasting glucose
• Fasting lipids

Although these aren't blood tests, consider getting your blood pressure checked often as well as measuring your waist circumference. If you're pregnant, your waist circumference will change - so keep that in mind.

References

Cooney, L., & Dokras, A. (2018). Beyond fertility: polycystic ovary syndrome and long-term health. Fertility And Sterility, 110(5), 794-809. doi: 10.1016/j.fertnstert.2018.08.021