What happens if PCOS is left untreated?

Woman with abdominal pain

PCOS or polycystic ovary syndrome is a complex endocrine disorder that causes symptoms such as irregular menstrual cycles, infertility, excessive face and body hair, acne, and weight gain.

The medical term polycystic means, ‘composed of many cysts.’ Multiple cysts manifest in the ovaries when hormone imbalance interrupts the ovulation process.

If polycystic ovary syndrome is left untreated, the syndrome may lead to serious, life-threatening illnesses such as cardiovascular and heart disease, type 2 diabetes, stroke, and uterine and endometrial cancers. Therefore, PCOS treatment is critical and one cannot afford to ignore!

Symptoms of untreated PCOS?

Because it is a syndrome, it includes a set of symptoms. The severity of each untreated PCOS symptom can vary widely from woman to woman. Some women may experience only one of the symptoms while other women may experience all of them.

Moreover, this is a syndrome that affects women of all ages — from adolescence to menopause. It also does not discriminate any specific race of women although research has shown that it tends to be more common with women of the Mediterranean descent.

Untreated PCOS symptoms

  • Chronic irregular menstrual cycles or lack of periods
  • Difficulty conceiving (due to not ovulating)
  • Obesity (20% greater than over ‘ideal’ weight)
  • Adult acne
  • Excessive unwanted hair growth (especially dark coarse hair on the face, chest, or abdomen)
  • Male pattern baldness (hair loss or hair thinning)
  • Insulin resistance or type 2 diabetes

As per research, some variations have been found in PCOS symptoms among different races. For example, excessive body hair is common among western women with PCOS, while it only occurs about 10 to 20% among the Asian women.

Consequences of Untreated PCOS

Untreated PCOS causes both short term and long term complications. PCOS complications can be mild, moderate, or severe. However, depending upon the individual’s cardiometabolic implications, every woman has a specific form of PCOS complication.

PCOS complications are as varied as the condition itself with the scope of every symptom of PCOS exacerbating.

PCOS Complications

  • Metabolic complications
  • Cardiovascular diseases
  • Gynecological diseases
  • Fertility/Pregnancy complications
  • Psychiatric complications

Metabolic Complications of PCOS

With complex nature and multifold symptoms, PCOS causes many metabolic complications. Known as a metabolic syndrome, it is a set of combined disorders that is characterized by high fasting blood sugar levels, excess abdominal fat, high levels of cholesterol, and high blood pressure. Women with untreated PCOS have metabolic syndrome and are prone to cardiovascular diseases.

Metabolic complications of untreated PCOS include:

  • Obesity
  • Hyperinsulinemia (high levels of insulin)
  • Dyslipidemia (high LDL, and triglycerides)
  • Cardiovascular diseases
  • Thromboembolism

Having metabolic complications like high blood pressure, high cholesterol and triglycerides, high fasting blood sugar levels, and obesity in unmanaged or untreated PCOS is a huge risk factor for serious diseases. Lifestyle modifications including weight reduction with dietary modifications and exercise, and medical management can reduce metabolic complications of PCOS.

Cardiovascular complications of PCOS

Women with unmanaged or untreated PCOS are more prone to heart and cardiovascular diseases. This is because of a wide range of coexisting conditions like insulin resistance, high cholesterol and triglyceride levels, and high blood pressure. Even women who are not obese, but have PCOS are prone to cardiovascular and heart risks.

A major contributor for the cardiovascular and heart complications of PCOS is the oxidative stress that abnormal hormones cause. Added to that, the levels of antioxidants in women with PCOS is lesser.

Apart from oxidative stress, higher levels of LDL cholesterol and triglyceride levels, insulin resistance, weight gain, and high blood pressure increase cardiovascular disease risks.

Cardiovascular Diseases in PCOS

  • Coronary heart disease
  • Arteriosclerosis
  • Atherosclerosis
  • Stroke

Gynecological diseases in PCOS

Though PCOS has numerous manifestations, one of the major set of symptoms that PCOS causes is gynecological. With irregular periods, anovulation, oligomenorrhea, and the risk of ovarian cancer endometrial cancer, and breast cancer, PCOS causes major gynecological complications.

Irregular periods, lack of ovulation, and infertility in PCOS is caused due to abnormal levels of androgens, and luteinizing hormones. These conditions are generally managed with the help of medication, and lifestyle modification involving diet changes and weight reduction.

Fertility & Pregnancy Complications in PCOS

Most women with PCOS have infertility or subfertility due to reduced anovulation. Though the chances of conceiving can be improved for women with PCOS, they are at an increased risk of pregnancy complications. Pregnancy complications in PCOS include:

  • Increased pregnancy-induced hypertension
  • Preeclampsia
  • Gestational diabetes
  • Premature delivery
  • Early pregnancy loss
  • Increased risk of miscarriage

Psychiatric Complications of PCOS

Along with many other physical complications of PCOS, there are certain psychiatric complications of PCOS. PCOS causes irregular periods, excess facial hair, and weight gain. All these symptoms have psychological consequences leading to anxiety, depression, and deep distress. Women with PCOS need proper support, counselling, and when necessary, psychiatric consultations.

When left undermanaged or untreated, PCOS can lead to a host of complications that lead to hospitalization. That is why it is important to consult endocrinologists, and gynecologists for proper management.