Complications of Polycystic ovary syndrome

Complications list for Polycystic ovary syndrome: The list of complications that have been mentioned in various sources for Polycystic ovary syndrome includes:

• Overweight
• Obesity
• Ovarian cysts
• Follicular cysts (type of Ovarian cysts)
• Enlarged ovaries (see Ovary symptoms)
• Subfertility
• Infertility
• Female infertility
• Insulin resistance
• IGT
• Diabetes
• Type 2 diabetes
• Gestational diabetes - during pregnancy
• Depression
• Mood swings (see Moodiness)
• Poor self-esteem (see Self-esteem symptoms)

Complications of Polycystic ovary syndrome: PCOS can negatively affect fertility since it can prevent ovulation. Some women with PCOS have menstrual periods, but do not ovulate. A woman with PCOS may be able to take fertility drugs, such as Clomid, or injectable fertility medications to induce ovulation. To help ovulation occur, women also can take insulin-sensitizing medications or steroids (to lower androgen levels). Some research also shows that taking low doses of aspirin, which helps prevent blood clotting in the uterine lining and improves blood flow, can improve chances of pregnancy.

There appears to be a higher rate of miscarriage in women with PCOS (possibly by 45%). The reason for this is being studied. Elevated levels of leuteinizing hormone, which aids in secretion of progesterone, may play a role. Elevated levels of insulin and glucose may cause problems with development of the embryo. Insulin resistance and late ovulation (after day 16 of the menstrual cycle) also may reduce egg quality, which can lead to miscarriage. The best way to prevent miscarriage in women with PCOS is to normalize hormone levels to improve ovulation, and normalize blood sugar, glucose, and androgen levels. Recently, more doctors are prescribing the drug metformin to help with this.

Since PCOS causes high glucose levels, it can be helpful for pregnant women with PCOS to have earlier screenings for gestational diabetes during pregnancy. Gestational diabetes occurs when a woman’s ability to process glucose is impaired. The baby also has trouble processing glucose, which can lead to a large baby, immature lungs, and birthing problems. Although a carefully balanced diet and/or insulin injections have been used to control gestational diabetes, there is new evidence that high insulin levels also can be damaging. Some doctors allow pregnant women with PCOS to continue taking metformin in pregnancy, while others won’t prescribe it to women trying to conceive. There is no evidence that it causes birth defects, but the long-term effects on the baby are not known. Women and their doctors should discuss the risks and benefits of medications. Women taking medication usually are monitored more closely. After pregnancy, many women with PCOS develop normal menstrual cycles and find it easier to become pregnant again. ¹

Irregular menstrual periods and the absence of ovulation cause women to produce estrogen, but not progesterone. Without progesterone, which causes the endometrium to shed each month as a menstrual period, the endometrium may grow too much and undergo cell changes. This is a pre-cancerous condition called endometrial hyperplasia. If the thickened endometrium is not treated, over a long period of time it may turn into endometrial cancer. PCOS also is linked to other diseases that occur later in life, such as insulin resistance, Type II diabetes, high cholesterol, hardening of the arteries (atherosclerosis), high blood pressure, and heart disease.

Depression or mood swings also are common in women with PCOS. Although more research is needed to find out about this link, there are studies linking depression to diabetes. Therefore, in PCOS, depression may be related to insulin resistance. It also could be a result of the hormonal imbalances and the cosmetic symptoms of the condition. Acne, hair loss, and other symptoms of PCOS can lead to poor self-esteem. Infertility and miscarriages also can be very stressful. Medications that restore the balance to hormone levels or antidepressants can help these feelings. ¹

Footnotes:
1. excerpt from Polycystic Ovary Syndrome (PCOS): NWHIC

Last revision: June 10, 2003

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