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Associated risks for PCOS can include:
Insulin resistance
Insulin resistance is a state where the body can't carry out the normal actions of insulin. One of the roles of insulin is to keep the levels of glucose in the blood stable. In PCOS high levels of insulin can increase the production of male hormones (androgens such as testosterone) in the ovaries. This contributes to symptoms such as menstrual irregularity, difficulty in ovulating and excessive hair growth and acne. Up to 80 per cent of women with PCOS have insulin resistance. Being overweight can contribute to insulin resistance
Weight gain and obesity
PCOS can occur in both slender and overweight women; however up to 75 per cent of women with PCOS are overweight or obese. This excess weight is more likely to be concentrated around the abdominal (stomach) region. This gives women with PCOS an ‘apple' shape. Women without PCOS tend to be a ‘pear' shape, with weight concentrated around the hips, buttocks and thighs.
Being overweight, and especially having a high amount of abdominal obesity, is associated with a higher risk of insulin resistance, which may lead to problems with fertility, and is associated with having a higher risk of type 2 diabetes and cardiovascular disease (including high blood pressure and heart disease) later in life.
A simple tool to assess if you are overweight or obese is the Body Mass Index or BMI. This is calculated as your weight (in kilograms) divided by your height squared (in metres).
For example, a woman who weighs 90 kg and is 167 cm tall, will have a BMI of:
| Weight (kg) |
|
Height (m2) |
|
BMI |
| 90 |
÷ |
1.672
(i.e. 1.67 x 1.67) |
= |
32.3 |
| |
|
|
Underweight =
|
BMI less than 20 |
| Normal weight = |
BMI between 20 and 25 |
| Overweight = |
BMI between 25 and 30 |
| Obese = |
BMI greater than 30 |
It is important to be aware that ‘waist lost' is just as important as ‘weight loss' in women with PCOS and that even losing 5-10 per cent of your original body weight can improve symptoms.
Prediabetes and type 2 diabetes
Compared to women without PCOS, women with PCOS have a much higher risk of developing pre-diabetes (impaired glucose tolerance) and type 2 diabetes. Women with PCOS are also more likely to develop diabetes in their 30s and 40s. Up to 40 per cent of women with PCOS will develop type 2 diabetes. This risk is further increased by being overweight or obese, insulin resistant, or by having a first degree relative (immediate family member) with diabetes.
Cardiovascular disease (heart disease)
Women with PCOS have a range of risk factors for cardiovascular disease such as:
Women with PCOS also have a greater risk of high blood pressure and increased signs of early cardiovascular disease in the blood vessels.
Metabolic syndrome
Women with PCOS also have a higher prevalence of ‘metabolic syndrome'. Metabolic syndrome is a condition where there is a cluster of diagnoses including impaired glucose tolerance, high blood pressure, abdominal obesity and high blood cholesterol. Together these factors are strongly associated with insulin resistance and an increased risk of developing type 2 diabetes and cardiovascular disease.
Endometrial cancer
When chronic anovulation (lack of egg being released regularly) occurs, this leads to a lack of menstruation or shedding of the lining of the uterus (endometrium). The endometrium can thicken which can increase the risk of abnormal cells that, as a woman ages, can develop into cancerous cells. This risk can be greatly reduced with treatments such as the oral contraceptive pill, which can improve the regularity of the menstrual cycles and the shedding of the uterine lining during menstruation. Adequate exercise, and having a healthy body weight can also assist in normalising periods and reducing the risk endometrial cancer.
Content updated July 31, 2009
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PCOS Risks 
