Polycystic ovary syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
If left untreated patients with PCOS may develop cardiovascular diseases due to elevated cholesterol and increased levels of androgens. Increased lengths of time without a menstrual period leads to unopposed exposure of endometrium to estrogen can result in uterine cancer. Complications that can develop as a result of polycystic ovary syndrome are insulin resistance/type II diabetes, high blood pressure, dyslipidemia, strokes, miscarriage, and infertility. The prognosis for fertility in patients with polycystic ovary syndrome is good with treatment, unless there are other unknown fertility problems.
Natural History
If left untreated patients with PCOS may progress to cardiovascular diseases due to elevated cholesterol and increased levels of androgens. Increased lengths of time without a menstrual period leads to unopposed exposure of endometrium to estrogen which may result in uterine cancer.[1][2]
Complications
Complications that can develop as a result of polycystic ovary syndrome are:[3][4]
- Endometrial hyperplasia and endometrial cancer
- Insulin resistance/Type II diabetes
- High blood pressure
- Dyslipidemia
- Cardiovascular disease
- Strokes
- Miscarriage
- Infertility
Prognosis
- The prognosis for fertility in patients with polycystic ovary syndrome is good with treatment, unless there are other unknown fertility problems.[5]
- Regular follow-up is recommended to avoid ovarian hyperstimulation, multiple pregnancies, and endometrial hyperplasia.
- Patients should be counseled regarding the long-term risk of diabetes, hypertension, and endometrial hyperplasia, including the importance of maintaining a BMI <25 kg/m2 and control of other risk factors for type 2 diabetes.
References
- ↑ Palomba S, Santagni S, Falbo A, La Sala GB (2015). "Complications and challenges associated with polycystic ovary syndrome: current perspectives". Int J Womens Health. 7: 745–63. doi:10.2147/IJWH.S70314. PMC 4527566. PMID 26261426.
- ↑ Harris HR, Terry KL (2016). "Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review". Fertil Res Pract. 2: 14. doi:10.1186/s40738-016-0029-2. PMC 5424400. PMID 28620541.
- ↑ Barry JA, Azizia MM, Hardiman PJ (2014). "Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis". Hum. Reprod. Update. 20 (5): 748–58. doi:10.1093/humupd/dmu012. PMC 4326303. PMID 24688118.
- ↑ Spritzer PM, Morsch DM, Wiltgen D (2005). "[Polycystic ovary syndrome associated neoplasms]". Arq Bras Endocrinol Metabol (in Portuguese). 49 (5): 805–10. doi:/S0004-27302005000500022 Check
|doi=value (help). PMID 16444364. - ↑ Balen A (2001). "Polycystic ovary syndrome and cancer". Hum. Reprod. Update. 7 (6): 522–5. PMID 11727859.