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 can develop heart disease 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 uterus 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 can develop heart disease 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 uterus cancer.

Complications

Complications that can develop as a result of polycystic ovary syndrome are:

• 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.
• 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/m2and control of type 2 diabetes.

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