Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women during their reproductive years. It involves an imbalance of reproductive hormones, leading to various symptoms across body systems. While many symptoms can be managed, leaving PCOS unaddressed can lead to significant long-term health issues. Understanding these potential consequences is important for overall well-being.
Reproductive Health Concerns
Untreated PCOS often disrupts the reproductive system, primarily causing irregular or absent ovulation. Hormonal imbalance, especially elevated androgens, interferes with egg development and release. This lack of regular ovulation often results in difficulty conceiving, making infertility a common challenge. Irregular menstrual cycles also mean the uterine lining does not shed regularly.
For those who become pregnant, untreated PCOS increases the risk of adverse outcomes. This includes a higher likelihood of gestational diabetes, where blood sugar levels become too high during pregnancy, affecting both mother and baby. Preeclampsia, characterized by high blood pressure and organ damage, is also more common. Additionally, there’s an increased risk of preterm birth, before 37 weeks of pregnancy.
Metabolic and Cardiovascular Complications
Untreated PCOS increases the risk of metabolic complications, with insulin resistance as a central factor. Insulin resistance occurs when cells do not respond effectively to insulin, causing the pancreas to produce more to maintain normal blood sugar. Over time, this can progress to prediabetes, where blood sugar levels are higher than normal but not yet Type 2 diabetes. Without intervention, many with untreated PCOS will eventually develop Type 2 diabetes.
Chronic hormonal imbalances and metabolic dysregulation also contribute to a higher risk of cardiovascular disease. High blood pressure (hypertension) is more prevalent, increasing strain on the heart and blood vessels. Dyslipidemia (imbalance of lipids like high cholesterol and triglycerides) is another common finding, contributing to artery hardening and narrowing. These factors, combined with chronic low-grade inflammation, collectively increase the likelihood of developing heart disease.
Increased Cancer Risk
Leaving PCOS untreated elevates the risk of endometrial cancer. This cancer develops in the uterine lining, the endometrium. With untreated PCOS, irregular or absent menstrual periods mean the uterine lining is continuously exposed to estrogen without progesterone’s counterbalancing effect. Progesterone helps the uterine lining shed each month, preventing excessive buildup.
Without regular shedding, the endometrium can become abnormally thick, a condition called endometrial hyperplasia. This thickening can progress to atypical hyperplasia, a precancerous state. Over time, these abnormal cells can transform into cancerous cells, leading to endometrial cancer. Prolonged, unopposed estrogen stimulation without regular progesterone withdrawal is the primary mechanism driving this increased risk.
Psychological and Quality of Life Impacts
Beyond physical health, untreated PCOS can affect mental well-being and quality of life. Many experience psychological issues, including higher rates of depression and anxiety. These challenges are often exacerbated by visible PCOS symptoms like hirsutism (excessive hair growth in male patterns) and persistent acne. Androgenic alopecia (female pattern hair loss) also contributes to body image concerns and diminished self-esteem.
The ongoing struggle with unmanaged symptoms can lead to social withdrawal and reduced confidence. Untreated PCOS is also associated with an increased risk of sleep apnea, characterized by pauses in breathing during sleep. Sleep apnea impacts daily energy levels and cognitive function, can worsen other health issues, and diminish overall quality of life.