PCOS and Diabetes, Heart Disease, Stroke...

Ever heard of polycystic ovary syndrome (PCOS)? If you're a woman who has had trouble getting pregnant, you might have. Just about everyone else? Probably not.

PCOS is the most common cause of female infertility, affecting 6% to 12% (as many as 5 million) of US women of reproductive age. But it's a lot more than that. Women with PCOS are often insulin resistant, meaning they don't respond effectively to insulin so their bodies keep making more. Excess insulin is thought to increase the level of androgens (male hormones that females also have) produced by the ovaries (egg-producing organs), which can stop eggs from being released (ovulation) and cause irregular periods, acne, thinning scalp hair, and excess hair growth on the face and body.

What's more troubling, high insulin levels from PCOS can lead to serious health problems, especially for women who are obese:

• Diabetes —more than half of women with PCOS develop type 2 diabetes by age 40
• Gestational diabetes (diabetes when pregnant)—which puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life
• Heart disease —the risk of heart attack is 4 to 7 times higher compared to women the same age who don't have PCOS
• High blood pressure —which can damage the heart, brain, and kidneys
• High LDL ("bad") cholesterol and low HDL ("good") cholesterol—increasing the risk for heart disease
• Stroke —plaque (cholesterol and white blood cells) clogging blood vessels can lead to blood clots that in turn can cause a stroke

PCOS is also linked to depression and anxiety , though the connection is unclear.

What Causes PCOS?

The exact causes of PCOS aren't known at this time, but both weight and family history—which are in turn related to insulin resistance—appear to play a part.

Weight...

Does being overweight cause PCOS? Does PCOS make you overweight? The relationship is complicated and not well understood. Being overweight is associated with PCOS, but many women of normal weight have PCOS, and many overweight women don't.

Family History...

PCOS tends to run in families. Women whose mother or sister has PCOS or type 2 diabetes are more likely to develop PCOS.

...and Insulin Resistance

Lifestyle can have a big impact on insulin resistance, especially if a woman is overweight because of diet and lack of physical activity. Insulin resistance also runs in families. Losing weight will often help improve symptoms no matter what caused the insulin resistance.

Finding Out if You Have PCOS

Sometimes PCOS symptoms are clear, and sometimes they're less obvious. You may visit a dermatologist (skin doctor) for acne or hair growth, a gynecologist (doctor who treats medical conditions that affect women and female reproductive organs) for irregular monthly periods, and your family doctor for weight gain, not realizing they are all part of PCOS. Some women with PCOS will have just one symptom; others will have them all. Women of every race and ethnicity can have PCOS.

It's common for women to find out they have PCOS when they try to start a family, but it often begins soon after the first menstrual period, as young as age 11 or 12. It can also develop in the 20s or 30s.

To determine if you have PCOS, your doctor will check that you have at least 2 of these 3 symptoms:

1. Irregular periods or no periods caused from lack of ovulation
2. Higher than normal levels of male hormones that may result in excess hair on the face and body, acne, or thinning scalp hair
3. Multiple small cysts on the ovaries

Just having ovarian cysts isn't enough for a PCOS diagnosis. Lots of women without PCOS have cysts on their ovaries and lots of women with PCOS don't have cysts.

When Does it Matter?

PCOS is a lifelong health condition that reaches far beyond the child-bearing years. As women with PCOS get older, their risk for PCOS complications such as type 2 diabetes and heart disease grows. That's why lifestyle changes you can stick with are so important.

What You Can Do

See your health care provider if you have irregular monthly periods, are having trouble getting pregnant, or have excess acne or hair growth. If you're told you have PCOS, lifestyle changes such as losing weight if you're overweight and increasing physical activity can reduce insulin resistance, which can help control PCOS.

There are also medicines that can help you ovulate, as well as reduce acne and hair growth. Make sure to talk with your health care provider about treatment options.

Find Out More

CDC's Division of Diabetes Translation
PCOS Fact Sheet
Common Reproductive Health Concerns for Women
Infertility in Women
Being Physically Active
Diabetes Features & Spotlights
CDC Diabetes on Facebook
@CDCDiabetes on Twitter