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Are there other issues related to PCOS?

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3 fertility expert(s) answered this question

Answer from: Kate Davies, RN, BSc (Hons), FP Cert

Nurse, Independent Fertility Nurse Consultant & Coach at Fertility Industry Consultancy & Podcast Co-Host
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The long term consequences of PCOS can be quite debilitating, so for example, women with PCOS have an increased risk of both gestational diabetes (diabetes when they are pregnant) but also diabetes itself. So those are some things to really consider and to really think about your lifestyle choices to reduce your risk. The other risk is cardiovascular disease and that is something we do know, women who have got PCOS or have got greater risks of cardiovascular disease. But I think it’s also really important to think about the other, perhaps emotional risks that can be associated with PCOS. So if you do have PCOS and you feel it’s impacting on your self esteem and your confidence, that can increase your risk of stress and depression. There are lots of different things that need to be considered when you have PCOS and how best to manage your condition so that you are less likely to be at risk of these long term conditions.

Answer from: Sibte Hassan, MBBS, FCPS, MRCOG, MSc

Gynaecologist, Fertility specialist and Gynaecologist at London Womens Clinic
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PCOS is generally considered as a spectrum of problems which could be mild, moderate, severe and the common symptom of polycystic ovary are either hair growth because of increased male testosterone hormone in the body or some skin changes due to the same reason (acne) and the other thing could be if the ovarian function and hormonal imbalance is there, it can lead to menstrual irregularities. The irregular cycle which could possibly be heaviest in some cases or it could be a prolonged cycle or no periods at all for many many months. So, these are the common symptoms but as you mentioned the other problems, long-term problems, could be because it is a state where the estrogen hormone is as a baseline and tonically raised so it can lead to continuous stimulation of the lining of the womb and it gets thickened so it can lead to heavy menstrual periods but it can also lead to some cellular changes within the lining of the womb which could be precancerous or in very very few cases it could lead to cancer as well in the long term. Again due to the same reason, due to raised estrogen female hormone, it can sometimes lead to a breast problem which could be cancer of the breast in the long term. The hormonal problem in polycystic ovary is basically related to mainly insulin resistance. Insulin is a growth hormone and if the tissues are resistant to it, it cannot do its proper action which is to push the main energy source (glucose) into the cells so that cells can utilize that glucose to produce energy and if the tissues and cells are resistant, then as a compensatory mechanism there is more insulin secreted and because insulin is a growth hormone it can lead to weight gain. It can lead to more hunger, it can lead to more fat deposition and because it is a stress on the carbohydrate metabolism, patients can manifest changes of carbohydrate intolerance and diabetes mellitus. Diabetes mellitus, endometrial thick lining and cancer of the womb or cancer of the breast also because patient is overweight, they’re struggling with fertility sometimes, they’ve got menstrual cycle problems so, their mental health gets affected and it can lead to depression, poor self-esteem and things like that. These are long-term issues.

Answer from: Moses Batwala

Gynaecologist, Clinical Director, Consultant Gynaecologist and Fertility Specialist Sims IVF
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I think the main thing with PCOS is… at least for me, the one take home that I really want… It’s something which many patients approach me with, and they come saying ‘Oh I have Polycystic Ovarian Syndrome, that means the quality of my eggs is not as good as other women’. One; I’d say no, at least not in my books, women with PCOS… my success rate when I transfer embryos for them is the same success rate as a woman of the same age with a similar type of embryo. So I don’t think that women with Polycystic Ovarian Syndrome should think that the quality of their eggs is in any way lower. At least I haven’t seen that. However, they have a good ovarian reserve, but they shouldn’t think that that means that because they’ll have more eggs in later life it means that they maintain egg quality even in their later life, No! They have more eggs, but their eggs will also lose quality because that is something that unfortunately goes with female age, the older woman’s egg quality declines and that’s because women are born with all the eggs they’ll ever have. And just because we propose that women have lots of eggs doesn’t mean that quality… it does go down. And so my advice is the same; if you want to have children, if the circumstances are right try and have your children the younger you are because, in my books, youth is the biggest factor in your ability to conceive and get pregnant, the younger you are that means the younger your eggs, then the better quality they are and the better quality they are the higher the chances that you will get pregnant.

About this question:

What other conditions are associated with PCOS?

Apart from difficulties in getting naturally pregnant there are other serious health problems that women with PCOS are more likely to develop. Those conditions are: diabetes, high blood pressure, cardiovascular problems and uterine cancer. This condition cannot be taken lightly.

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