At Risk For Diabetes: Women with PCOS

PCOS put women at a greater risk of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and cancer.

Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. With PCOS, women typically have:

  • high levels of androgens. These are sometimes called male hormones, although females also make them.
  • missed or irregular periods.
  • many small cysts in their ovaries. Cysts are fluid-filled sacs.

About one in 10 women of childbearing age has PCOS. It can occur in girls as young as 11 years old. PCOS is the most common cause of female infertility. This term has also become a catch-all phrase for the wide variations of symptoms affiliated with insulin resistance in women.

The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with the disease.

Researchers also think insulin could be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body.

Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.

Despite the fact that most researchers think PCOS runs in families, there is no proof that it is inherited.

What are the symptoms?

Not all women with PCOS share the same symptoms.

These are some of the symptoms of PCOS:

  • infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
  • infertility because of not ovulating
  • increased hair growth on the face, chest, stomach, back, thumbs, or toes -- a condition called hirsutism.
  • ovarian cysts
  • acne, oily skin, or dandruff
  • weight gain or obesity, usually carrying extra weight around the waist
  • insulin resistance or type 2 diabetes
  • high cholesterol
  • high blood pressure
  • male-pattern baldness or thinning hair
  • patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
  • skin tags, or tiny excess flaps of skin in the armpits or neck area
  • pelvic pain
  • anxiety or depression due to appearance and/or infertility
  • sleep apnea -- excessive snoring and times when breathing stops while asleep

What's the big deal if I have it?

Women with PCOS have greater chances of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and cancer.

Recent studies found that:

  • More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
  • Women with PCOS have a four to seven times higher risk of heart attack than women of the same age without PCOS.
  • Women with PCOS are at greater risk of having high blood pressure.
  • Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.

The chance of getting endometrial cancer is another concern for women with PCOS. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium to shed its lining each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.

What treatments are available?

  • Birth control pills
  • Diabetes medications
  • Fertility medications
  • Anti-androgen medication
  • Surgery
  • Lifestyle modification

How is it diagnosed?

Identifying, addressing, and getting your symptoms under control at an earlier age can help to reduce your chances of having complications like diabetes and heart disease. This condition is often overlooked by physicians. If diagnosed with PCOS, then develop a plan of action for its treatment. Talk to your doctor about treating all your symptoms, rather than focusing on just one aspect of your PCOS, such as problems getting pregnant. Also, talk to your doctor about getting tested for diabetes regularly. Eating right, exercising, and not smoking also will help to reduce your chances of having other health problems.

Resources: National Women's Health Information Center www.Womenshealth.gov ; Polycystic Ovarian Syndrome Association www.pcosupport.org.