PCOS Is No Longer Just a Reproductive Disorder: Understanding Its Long-Term Health Impact

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For years, Polycystic Ovary Syndrome (PCOS) was discussed largely through the lens of missed periods, acne, unwanted hair growth and difficulty conceiving. In clinics today, however, PCOS is increasingly recognised for what it truly is: a lifelong metabolic and hormonal condition that can influence a woman's health well beyond the reproductive years.

We spoke to Dr Anita David- Consultant Gynaecologist, Infertility Specialist, Vaginal & Laparoscopic Surgeon (Obstetrics and Gynaecology), MBBS, DGO, DNB -OBG, HOSMAT Hospitals, 18 years experience, who explained the long-term impact of PCOS on your health.

Globally, the World Health Organization estimates PCOS affects around 8-13% of women of reproductive age. In India, the numbers vary depending on diagnostic criteria and population studies, but a systematic review and meta-analysis reported a pooled prevalence of about 11% using commonly used criteria. This means PCOS is not 'rare' - it is common, under-recognised, and often undertreated beyond symptom control.

The Hidden Long-Term Risks

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"PCOS is closely linked with insulin resistance, which helps explain why many women with PCOS face higher long-term risks of prediabetes and type 2 diabetes. Public health guidance from the US CDC notes that more than half of women with PCOS may develop type 2 diabetes by age 40, a statistic that underlines how early the metabolic impact can begin," explained Dr David.

Cardiovascular health is another concern. The 2023 International Evidence-Based Guideline for PCOS emphasises the importance of recognising cardiometabolic risk and assessing factors like weight, blood pressure, glucose and lipids as part of routine PCOS care, not just fertility-focused management.

Emerging evidence also links PCOS with a higher risk of metabolic dysfunction-associated fatty liver disease (formerly NAFLD/MASLD) and sleep-disordered breathing, especially when weight gain and insulin resistance coexist.

"And there is a dimension we still don't talk about enough: mental health. PCOS can affect body image, self-esteem, relationships and quality of life. The 2023 guideline specifically highlights the need to screen for psychological well-being as part of PCOS care, not as an afterthought," added Dr David.

Why PCOS is Missed, or Minimised

"Many women are told to 'just lose weight' or 'take a pill for periods.' But PCOS is heterogeneous: some women have irregular cycles with normal weight, others have prominent metabolic issues, and some have distressing skin/hair symptoms. A one-size-fits-all approach fails," said Dr David.

Practical Takeaways: What Women with PCOS Should Monitor

If you have PCOS (or suspect it), discuss a long-term screening plan with your doctor. Most women benefit from periodic checks of:

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• Weight/BMI and waist circumference
• Blood pressure
• Glucose testing (fasting glucose, HbA1c, or an oral glucose tolerance test when indicated)
• Lipid profile (cholesterol and triglycerides)
• Sleep symptoms (snoring, daytime sleepiness)
• Mood screening (anxiety/depressive symptoms)
• Cycle regularity (important for endometrial protection)

Bottomline

Dr David concluded, "PCOS care should not begin and end with periods or pregnancy. It should be framed as whole-person, lifelong healthcare, metabolic, cardiovascular, psychological and reproductive. With early diagnosis, sensible screening and sustainable lifestyle support, most women with PCOS can significantly reduce long-term risks and lead healthy, active lives."

If there's one message to remember, it is this: PCOS is manageable, but only when we treat it as more than a fertility problem.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.