Long term health care for women with PCOS

Patients with PCOS should have regular specialist monitoring to prevent most if not all the risk factors mentioned before. Screening should include annual recording of weight, measurement of waistline, blood pressure, checking for insulin resistance and abnormal lipid profile.

Proper control of weight would reduce insulin resistance and the increased risk of type 2 diabetes especially after the age of 40 years.


Care should be taken to prevent endometrial hyperplasia which could follow prolonged unopposed exposure to oestrogen especially in overweight patients with irregular periods.

Proper selection of an oral contraceptive pill would protect the endometrium against hyperplasia and consequently endometrial cancer. Using the oral contraceptive pill could also protect against ovarian cancer which was reported to be 2-3 times more common in women with PCOS.


However care should be taken to select pills with non-androgenic progestogen to guard against a bad effect on carbohydrate tolerance. Examples of PCOS friendly pills are mercilon, yasmin, cilest, marvelon, femodene, femodette, minulet. Recently, Yaz is becoming more popular in this respect because of its small dose of oestrogen (20 ug) and drospirone as the progestational component.


With advancing age non obese women with PCO tend to have more regular periods, lower circulating androgens and loss of the PCO pattern. These changes could be secondary to the age related reduction in the total number of recruitable follicles and the increase in FSH level leading to a more favourable LH / FSH ratio.

 

 
 
 
 
 


 
 
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