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the other long-term health conditions listed below.
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Infertility
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This is defined as an inability to conceive after one year of regular unprotected sex. PCOS causes problems with ovulation due to imbalances in the hormones LH (luteinizing hormone) and FSH (follicle stimulating hormone). If a woman isn’t ovulating she can’t conceive, so PCOS is linked to infertility. But some women with PCOS ovulate, some ovulate occasionally, and others are only ever infertile for the odd month or two.
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Miscarriage
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This is the loss of a pregnancy, normally before 14 weeks. Women with PCOS, who have high levels of Luteinizing Hormone, may be at greater risk of early pregnancy loss. Of women with recurrent miscarriage, more than 80 per cent have been identified as having polycystic ovaries.
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Eating disorders
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A recent study suggested that PCO/S does not cause eating disorders,11 but since many women with PCOS have problems controlling their weight it is hardly surprising that as many as 60 per cent of women with PCOS have ‘disordered eating’ patterns such as bulimia.
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Cholesterol problems
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A low level of the ‘good’ cholesterol – high density lipoprotein (HDL) – and an increased level of the ‘bad’ cholesterol – low density lipoprotein (LDL) – together with high triglyceride levels are seen in women with PCOS, particularly those who have insulin resistance.12 This situation is associated with the risk of developing both heart disease and non-insulin-dependent (Type II) diabetes. Healthy eating and exercise can and are proven ways to help.
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High blood pressure
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Women with PCOS are four times more likely to suffer from high blood pressure than other people of the same age and weight. High blood pressure is an independent risk factor for heart disease.13
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Non-insulin dependent diabetes
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Research has shown that insulin resistance plays a significant role as both a cause and symptom of PCOS. A woman with PCOS is seven times more likely to develop diabetes during her lifetime than the rest of the population.14
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Gestational diabetes
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The increased incidence of hyperinsulinism and insulin resistance means that if you have PCOS you are likely to develop diabetes during pregnancy. This gestational diabetes can be associated with complications during pregnancy. After the pregnancy this type of diabetes commonly resolves, but there is an increased risk of it reappearing in later life.
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Cardiovascular disease
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Using the risk factors for cardiovascular disease which have been identified in women with PCOS, it is thought that they have a sevenfold increased risk of having a heart attack when compared to the general population.15
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Endometrial cancer
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We don’t know if there is direct evidence of a link between PCOS and endometrial cancer, but we do know that this cancer is oestrogen-driven. If you have no periods, your womb lining doesn’t shed, and this unshed, thicker lining can promote the cell changes linked to endometrial cancer.
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Endometriosis
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It is not uncommon to see both PCO/S and endometriosis in the same woman. Are the two conditions linked? No one really knows the answer at present. Endometriosis is a condition where tissue similar to the lining to the womb grows at other sites in the body outside the womb – commonly in the pelvis, on the ovaries and in the bowel, but also in rare cases on the lungs, eye, thighs and arms. We do know that this aberrant growth is oestrogen-dependent. Since many women with PCOS and irregular periods have raised oestrogen levels with little or no opposing progesterone, this may make the situation worse for women who also have endometriosis.
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Ovarian cysts
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A 1996 study reported an increased risk of ovarian cancer among women with PCOS in a population-based, case-controlled study involving 426 cancer patients and 4,081 controls.16 The association was found to be stronger in those who had never used oral contraceptives. Many studies need to be done to verify these findings, and the link between PCOS and ovarian cancer is by no means established, but the relative protection offered by oral contraceptives needs to be taken into account when determining your choice of contraception.
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But don’t panic. Your body responds brilliantly to any help you give it to help prevent these health problems arising. Start now and you can reduce your risks.
First, change your food.
Eating well, managing stress, sleeping well and exercising regularly go a long way to keeping the doctor away and reducing the long-term health risks related to PCOS.
Many medical studies have shown that healthy eating can manage such conditions as diabetes. But paying attention to your diet can do more than manage health conditions like diabetes, it may even be able to prevent them occurring in the first place.
Diabetes
A 2001 Finnish study published in the New England Journal of Medicine suggests that a well-balanced diet can help to prevent diabetes in high-risk people. Researchers looked at over 500 overweight adults with impaired tolerance to glucose. The patients were divided into two groups, with the first group given advice from a nutritionist based on eating fewer fatty foods and more fruits and vegetables and cereals. They were also told about the benefits of exercise. The second group was not given this nutrition and exercise advice. After three years, 59 people in the second group developed diabetes, compared to only 27 in the group given eating and exercise guidelines.
Heart Protection
The British Heart Foundation dedicates itself to educating people about the dangers of high-fat, high-cholesterol diets. The message is clear: eating healthily can dramatically reduce your risk of a heart attack.
Increasing evidence has shown that eating five portions of fresh fruit and vegetables a day could cut the number of heart-disease and cancer deaths. In response to this evidence, doctors in one region of Britain have been prescribing vouchers which can be exchanged for fruit and vegetables. This experiment, taking place in the Wirral in the UK, aims to kick-start the changes in lifestyle and diet which can prevent illness.
Cancer
In 1997, the UK Government’s Department of Health Committee on Medical Aspects of Food and Nutrition Policy took a rare step in publishing a report entitled Nutritional Aspects of the Development of Cancer. The World Health Organization (WHO) also acknowledges the fundamental role nutritional well-being plays in human development and the prevention of diseases like cancer and heart disease. WHO Director General Harlem Brundtland states, ‘Nutrition is a cornerstone that affects and defines the health of all people rich and poor … malnutrition makes us all vulnerable to disease.’
Recent research published in the New England Journal of Medicine, studying 45,000 pairs of twins, found that cancer is largely caused by diet and lifestyle choices rather than inherited risk.17
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