6 conditions that PCOS can increase your risk of

Polycystic ovary syndrome (PCOS) is a condition that affects around one in 10 women in the UK. And though common, having PCOS can put you at an increased risk of several conditions, including: 

• Obesity and metabolic syndrome  
• Type 2 and gestational diabetes 
• Cardiovascular disease  
• Endometrial cancer 
• Non-alcoholic fatty liver disease 
• Obstructive sleep apnoea  
• Mood disorders 

If you have PCOS, it is helpful to know what you are at a higher risk of and how to check for these conditions.  

Most of (if not all) the risks below can be linked back to insulin resistance – which underpins PCOS. You can read more about insulin resistance in what every woman should know about PCOS.  

1. Type 2 and Gestational Diabetes

If you have PCOS, you have a significantly increased risk of developing both type 2 diabetes and gestational diabetes. The risk for these diseases is associated with PCOS as a sole condition but can increase if you are also overweight.  

Type 2 diabetes is a serious, lifelong condition that causes the level of glucose in the blood to become elevated and causes insulin imbalance. It can lead to complex health needs in the future.  

Gestational diabetes is diabetes that occurs during pregnancy but rather than being lifelong, usually disappears after giving birth. However, gestational diabetes can cause problems during your pregnancy and labour. 

Complications caused by gestational diabetes include: 

• A larger than normal baby 
• Pre-eclampsia 
• Premature birth 
• Jaundice 
• Stillbirth 

Having gestational diabetes also means that you are at increased risk of developing type 2 diabetes in the future. 

If you have PCOS, it is important that you screen regularly for type 2 diabetes and when pregnant, gestational diabetes. Your doctor can arrange either an oral glucose tolerance test or an HbA1c Blood Test. A diabetes screening should be done once diagnosed with PCOS and then every one to three years (depending on your age, ethnicity, and body mass index (BMI). 

2. Cardiovascular disease

Cardiovascular disease (CVD) remains a significant cause of death in women [1]. And PCOS has been linked to a risk of heart disease, especially among women who are premenopausal [2]. Therefore, it is sensible that women with PCOS are regularly monitored for CVD risk.  

Once you are diagnosed with PCOS, your doctor should assess your other risk factors for CVD. And depending on your risk factors, assess you again at intervals.  

Risk factors for CVD include: 

• High BMI 
• Increased visceral fat (fat that gathers around your organs and increases weight around the abdomen) 
• Smoking 
• High blood pressure 
• Elevated cholesterol  
• Impaired glucose tolerance 
• Lack of exercise  

To help reduce your risk of CVD, you can make certain lifestyle changes including: 

• Exercising 
• Eating a healthy, balanced diet 
• Maintaining a healthy BMI 

3. Endometrial Cancer

Endometrial cancer is cancer of the womb that is more commonly diagnosed in post-menopausal women [3]. Some studies have suggested that women with PCOS have a 2.7-fold increased lifetime risk of developing it [4].  

For women with PCOS, menstrual cycles can be longer than average. If your average cycle is longer than 90 days, you may be prescribed medication to help reduce your risk of endometrial cancer.  

It is important to seek advice from your doctor if you have gone a long time without having a period or notice abnormal vaginal bleeding. Your doctor can organise a uterine scan to assess the thickness of your womb lining (endometrium), and check for conditions such as endometriosis.  

4. Non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a term used to describe a range of conditions caused by the build-up of fat in the liver. Some women with PCOS may develop NAFLD, and this in turn can increase the risk of developing several health conditions.  

NAFLD increases your risk of developing health conditions including: 

• Diabetes 
• High blood pressure 
• Kidney disease 

Symptoms of NAFLD include: 

• Abdominal pain in the upper right quadrant 
• Extreme tiredness 
• Unexplained weight loss 
• Feelings of weakness 

To diagnose NAFLD, your doctor may perform a few tests including a Liver Blood Test, an ultrasound scan, and on some occasions, a liver biopsy. 

There is no specific drug treatment for NAFLD, but certain lifestyle changes can help to manage symptoms and reduce the risk of developing associated conditions. 

Ways to manage NAFLD include: 

• Losing weight 
• Eating a healthy diet 
• Quitting smoking 
• Reducing alcohol  
• Regular exercise 

5. Obstructive sleep apnoea

Women with PCOS are twice as likely to develop OSA than women without the condition [5]. 

OSA is characterised by a frequent complete or partial obstruction of the airway as you sleep. Many people don't know that they have OSA, and it may be their partner who first becomes aware of it.  

Symptoms of OSA include: 

• Snoring 
• Choking or gasping during sleep 
• Frequent waking  

OSA can be exacerbated by being overweight, hence why women with PCOS may experience this symptom.  

If you have OSA you may notice that you: 

• Feel fatigued  
• Find it difficult to concentrate 
• Have mood swings 
• Have headaches when you wake in the morning 

If you think you may have OSA, it is important to speak with your doctor. Your doctor may not treat mild OSA, but if it’s severe, there are treatments available to help you get better quality sleep and therefore less fatigued during the day. 

6. Mood disorders

People with PCOS are more likely to have depression, anxiety, and eating disorders (particularly binge eating) [6].  

PCOS is a debilitating condition, both physically and emotionally. If you feel that your mood is affected, take the time to discuss this with your doctor, as you do not need to suffer in silence.   

You can read more about where to get support in what every woman needs to know about PCOS.   

What can I do about my risk of other health conditions with PCOS? 

When you are diagnosed with PCOS, you should be screened for certain conditions that the condition puts you at higher risk.  

However, you can take your health into your own hands by testing certain biomarkers to see your risks for things like diabetes and NAFLD. You can do this with our Advanced Well Woman Blood Test which tests for key biomarkers including: 

• Liver health 
• Diabetes risk  
• Female hormones  

---

References 

1. England, N., 2022. NHS England » Cardiovascular disease (CVD). [online] England.nhs.uk. Available at: <https://www.england.nhs.uk/ourwork/clinical-policy/cvd/> [Accessed 16 June 2022]. 
2. Ramezani Tehrani, F., Amiri, M., Behboudi-Gandevani, S., Bidhendi-Yarandi, R. and Carmina, E., 2019. Cardiovascular events among reproductive and menopausal age women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecological Endocrinology, 36(1), pp.12-23.
3. National Cancer Institute. 2022. Closer Look at Postmenopausal Bleeding and Endometrial Cancer. [online] Available at: <https://www.cancer.gov/news-events/cancer-currents-blog/2018/endometrial-cancer-bleeding-common-symptom> [Accessed 16 June 2022]. 
4. Ignatov, A. and Ortmann, O., 2020. Endocrine Risk Factors of Endometrial Cancer: Polycystic Ovary Syndrome, Oral Contraceptives, Infertility, Tamoxifen. Cancers, 12(7), p.1766. 
5. Kumarendran, B., Sumilo, D., O’Reilly, M., Toulis, K., Gokhale, K., Wijeyaratne, C., Coomarasamy, A., Arlt, W., Tahrani, A. and Nirantharakumar, K., 2019. Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study. European Journal of Endocrinology, 180(4), pp.265-272. 
6. Krug, I., Giles, S. and Paganini, C., 2019. &lt;p&gt;Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies&lt;/p&gt;. Neuropsychiatric Disease and Treatment, Volume 15, pp.1273-1285.