Why PCOS Is More Than A Fertility Disorder - How It Contributes To Diabetes, Obesity, and Anxiety?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder in women of reproductive age. It is characterised by high androgen, or male hormone, levels, irregular periods, and polycystic ovaries, though cysts are not always present.

It is true that PCOS is the leading cause of infertility in women, caused by hormonal imbalances that lead to irregular or absent periods and lack of ovulation (anovulation). However, the assumption that PCOS is just a fertility problem is wrong. PCOS goes beyond fertility issues and can also lead to other health concerns.

Speaking with the OnlyMyHealth team, Dr Kajal Singh, Associate Professor, Obstetrics and Gynaecology Department, NIIMS Medical College and Hospital, Noida, says, "PCOS is often discussed in the context of irregular periods and difficulty getting pregnant... (but) it is actually a hormonal and metabolic condition that can impact skin, hair, weight, mental health, long-term health risks, and beyond.

"Fertility is one component of a larger syndrome,” she shares.

Also Read: Diagnosed With PCOS After Moving To Canada: Here’s How 22-Year-Old Bhavya Gulati Took Control and Reversed It

PCOS And Metabolic Problems

PCOS is strongly linked to metabolic problems like insulin resistance, dyslipidaemia (unhealthy cholesterol levels), and high blood sugar, which increase the risk of developing metabolic syndrome, type 2 diabetes, and cardiovascular disease.

A 2012 study of women with PCOS, published in the Journal of Human Reproductive Sciences, found that nearly 4 in 10 had metabolic syndrome, a cluster of risks for heart disease and diabetes. High cholesterol was common, and some had diabetes or prediabetes.

Women over 25 or with more belly fat were at the greatest risk, suggesting regular screening can help catch and manage these health issues early.

According to Dr Singh, there is often a relationship between PCOS and insulin resistance, meaning the insulin that the body produces is less effective at facilitating the use of the insulin in the body, resulting in higher levels of insulin in the blood.

"Over time, the body will put on weight in the abdominal area and further increase hormone imbalances while also increasing the predisposition to type 2 diabetes, prediabetes, or metabolic syndrome," she explains.

Mental Health Issues Associated With PCOS

PCOS is often associated with several mental health issues, including depression, anxiety, and eating disorders. These, according to Dr Singh, can stem from the hormonal imbalances, visible symptoms like acne or hair growth, fertility concerns, and the chronic stress of managing the condition.

She says, "Researchers have found that women with PCOS have a higher likelihood of being diagnosed with mood disorders compared to women without PCOS. Having mental health support is just as important as medical treatment."

Also Read: How To Distinguish Between PCOS Acne Vs. Normal Acne

Role Of Weight Management For PCOS

Weight management doesn’t 'cure' PCOS, but a 5-10% reduction in body weight can help regulate periods, improve insulin sensitivity, lower male-hormone levels, and improve chances of fertility, explains Dr Singh.

However, not all women with PCOS are overweight; therefore, management of lifestyle should be individualised, looking at the lifestyle components of nutrition, movement, and metabolic health, not just body composition.

A review published in Expert Review of Endocrinology & Metabolism highlights that weight loss is associated with improved metabolic, endocrine, reproductive, cardiovascular and psychological features in overweight and obese women with PCOS. 

How To Manage PCOS Without Making It Just A Fertility Problem

According to Dr Singh, PCOS management should be multidimensional:

• Lifestyle: Balanced diet, regular exercise, good sleep.
• Medical care: Hormonal pills, insulin-sensitising drugs, or specific symptom treatments if needed.
• Mental health support: Counselling or stress management.
• Long-term health monitoring: Regular screening for diabetes, cholesterol, and blood pressure.
• Self-care: Addressing skin/hair concerns, building support networks, and focusing on overall well-being.

Conclusion

PCOS is a condition caused by a disruption in hormone levels. While it can lead to fertility issues, there are other health complications that need to be considered while managing the condition. Metabolic conditions like diabetes are common among women with PCOS, especially those who are obese and overweight. Experts recommend managing weight, eating healthy, and exercising regularly.