Polycystic Ovary Syndrome

Causes of Polycystic Ovary Syndrome

The exact causes remain unclear but more than one can be involved. Genetic and environmental contributors combined with obesity, ovarian dysfunction and hormonal changes contribute to Polycystic Ovary Syndrome (PCOS).

Long-term risk

• Weight gain/obesity
• Insulin resistance and type 2 diabetes (T2DM)
  Adolescents and adult women with PCOS are at increased risk for Impaired Glucose Tolerance (IGT) and T2DM. A diagnosis of Polycystic Ovary Syndrome (PCOS) confers a 5- to10-fold increased risk of developing T2DM. The use of an Oral Glucose Tolerance Test - OGTT (consisting of a fasting and a 2-hour glucose level using a 75 g oral glucose load) is recommended to screen for IGT and T2DM.
• Cardiovascular disease
  Women with PCOS should be screened for the following cardiovascular disease risk factors: family history of early cardiovascular disease, cigarette smoking, IGT/ T2DM, hypertension, dyslipidaemia, obstructive sleep apnoea, and obesity (especially increased abdominal fatty tissue).
• Endometrial cancer
  Women with Polycystic Ovary Syndrome (PCOS) have a threefold increased risk of developing an endometrial cancer (cancer of the inner lining of the uterus). There is currently no data supporting routine endometrial biopsy of asymptomatic women or ultrasound screening of the endometrium. However, women should be counselled to report unexpected bleeding and spotting.
• Depression and mood swings
  Women with Polycystic Ovary Syndrome (PCOS) should be screened for depression and anxiety by history and, if identified, appropriate referral and/or treatment provided.