6 health risks associated with PCOS

Polycystic ovary syndrome (PCOS) is a condition that affects around one in eight women in the UK [1] . And though common, having PCOS can put you at an increased risk of several conditions such as diabetes, fatty liver disease, and more.

This article explains what conditions PCOS puts you at risk for, and how you can check your health in relation to them.

We explore:

1. PCOS and diabetes risk
2. PCOS and cardiovascular risk
3. PCOS and endometrial cancer
4. PCOS and liver conditions
5. PCOS and obstructive sleep apnoea
6. PCOS and mental wellbeing
7. Monitoring your health with PCOS

 

1. PCOS and diabetes risk
 

If you have PCOS, you have a significantly increased risk of developing both type 2 diabetes and gestational diabetes. It’s believed that regardless of weight, women with PCOS are 40% more likely to develop diabetes than those without. This number raises to 50% of you are of South East Asian descent [2].

The risk for diabetes associated with PCOS as a sole condition can increase if you are also overweight (a common symptom of PCOS).

Type 2 diabetes is a serious, lifelong condition that causes the level of glucose in the blood to become elevated and causes insulin imbalance. If left type 2 diabetes is left unmanaged, it can lead to complex health issues 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. 

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

How to test for diabetes

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. PCOS and cardiovascular risk
 

Cardiovascular disease (CVD) remains a significant cause of death in women. And PCOS has been linked to a risk of heart disease, especially among women who are premenopausal [3,4].

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 
• Genetics, such as your Lp(a) levels
• 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 

How to test for cardiovascular risk

There are a few ways to keep an eye on your cardiovascular health including measuring your heart rate and blood pressure. Additionally, taking a heart health blood test to check your cholesterol levels can give you insights into your cardiovascular risk. A Cholesterol Blood Test is a great way to start.

3. PCOS and risk of endometrial cancer
 

Endometrial cancer is the most common gynaecological cancer (cancer of the womb). Although it is more commonly diagnosed in post-menopausal women, some studies have suggested that women with PCOS are two to five times more at risk of developing endometrial cancer in their lifetime [5,6].

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.  

How to check for 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).

Remember, having PCOS doesn’t automatically mean you’ll develop endometrial cancer.

4. PCOS and liver conditions
 

If you have PCOS you may develop metabolic dysfunction-associated steatotic liver disease (MASLD) (formerly known as non-alcoholic fatty liver disease (NAFLD)). MASLD is a common condition caused by build-up of fat in the liver. One study showed that women with PCOS were four times more at risk of developing MASLD than women without PCOS [7].

You can read more about liver health and liver function tests in our useful guide. Usually, MASLD is associated with people who are overweight. But research shows that women with PCOS are more prone to liver issues even with a healthy BMI [8].

At first, MASLD doesn’t present with any symptoms and is often picked up when having tests for other reasons. Once it’s progressed to inflammation and scarring you may then start to notice symptoms.

These could include:

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

How to test for MASLD

A Liver Function Blood Test can be a good starting point to check if you have MASLD with PCOS. Women with PCOS often have higher levels of liver enzymes such as alanine aminotransferase (ALT).

Other tests for MASLD include ultrasound scans and a liver biopsy.

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

Ways to manage MASLD include: 

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

5. PCOS and sleep apnoea
 

Women with PCOS are twice as likely to develop obstructive sleep apnoea (OSA) than women without the condition [9,10].

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, but even if you are a healthy weight, you might still experience sleep apnoea [11].

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 

How to test for sleep apnoea

There isn’t yet a blood test for OSA. 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. PCOS and mental wellbeing
 

People with PCOS are more likely to have depression, anxiety, and eating disorders (particularly binge eating) [12].

How to test for depression and anxiety

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. 

Keep in mind that nutrient deficiencies and other internal imbalances can also contribute to lower mental wellbeing.

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

Being diagnosed with PCOS doesn’t mean your health is doomed. It just means that you are at a higher risk of developing certain conditions and therefore would benefit from being proactive about your health.

When you are first diagnosed with PCOS, your doctor should screen you for certain conditions, some of which we’ve covered in this article.

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References

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2. Long-term health. In: Verity - The UK PCOS Charity [Internet]. [cited 17 Feb 2026]. 
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4. Ramezani Tehrani F, Amiri M, Behboudi-Gandevani S, Bidhendi-Yarandi R, Carmina E. Cardiovascular events among reproductive and menopausal age women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecological Endocrinology. 2020;36: 12–23. doi:10.1080/09513590.2019.1650337
5. Ignatov A, Ortmann O. Endocrine Risk Factors of Endometrial Cancer: Polycystic Ovary Syndrome, Oral Contraceptives, Infertility, Tamoxifen. Cancers (Basel). 2020;12: 1766. doi:10.3390/cancers12071766
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9. Obstructive sleep apnoea (OSA). In: NHS inform [Internet]. [cited 16 Feb 2026]. 
10. He J, Ruan X, Li J. Polycystic ovary syndrome in obstructive sleep apnea-hypopnea syndrome: an updated meta-analysis. Front Endocrinol. 2024;15. doi:10.3389/fendo.2024.1418933
11. Kumarendran B, Sumilo D, O’Reilly MW, Toulis KA, Gokhale KM, Wijeyaratne CN, et al. Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study. Eur J Endocrinol. 2019;180: 265–272. doi:10.1530/EJE-18-0693
12. Krug I, Giles S, Paganini C. Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies. Neuropsychiatr Dis Treat. 2019;15: 1273–1285. doi:10.2147/NDT.S168944