Polycystic ovary syndrome natural history, complications and prognosis

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.

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 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

• 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.

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