Editing Polycystic ovary syndrome (section)

== Signs and symptoms ==
{{Cleanup section|date=December 2024|reason=This section repeats itself, may be longer than necessary, and may not be consistent with the introduction.}}

Signs and symptoms of PCOS include [[Irregular menstrual periods|irregular or no menstrual periods]], [[Menorrhagia|heavy periods]], [[hirsutism|excess body and facial hair]], [[acne]], pelvic pain, [[infertility|difficulty getting pregnant]], and [[acanthosis nigricans|patches of thick, darker, velvety skin]],<ref name="NICHD What are the symptoms of PCOS?">{{cite web |title=What are the symptoms of PCOS? |url=https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/symptoms |website=[[Eunice Kennedy Shriver National Institute of Child Health and Human Development]] |date=29 September 2022 |access-date=13 October 2021 |archive-date=9 October 2021 |archive-url=https://web.archive.org/web/20211009211043/https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/symptoms |url-status=live }}</ref> ovarian cysts, enlarged ovaries, excess [[androgen]]s, and weight gain.<ref name="vice.com">{{cite web|title=What We Talk About When We Talk About PCOS|url=https://www.vice.com/en/article/what-we-talk-about-when-we-talk-about-pcos/|access-date=19 January 2022|website=Vice.com|date=23 January 2019|language=en|archive-date=19 January 2022|archive-url=https://web.archive.org/web/20220119053818/https://www.vice.com/en/article/zmae5j/what-we-talk-about-when-we-talk-about-pcos|url-status=live}}</ref><ref>{{Cite web |date=28 February 2022 |title=Polycystic Ovary Syndrome (PCOS) |url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos |access-date=9 February 2023 |website=www.hopkinsmedicine.org |language=en |archive-date=10 February 2023 |archive-url=https://web.archive.org/web/20230210194350/https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos |url-status=live }}</ref>

Associated conditions include [[type 2 diabetes mellitus|type 2 diabetes]], [[obesity]], [[obstructive sleep apnea]], [[heart disease]], [[mood disorder]]s, and [[endometrial cancer]].<ref name="NIH2017Def" />

Common signs and symptoms of PCOS include the following:
* [[Menstrual disorder]]s: PCOS mostly produces [[oligomenorrhea]] (fewer than nine menstrual periods in a year) or [[amenorrhea]] (no menstrual periods for three or more consecutive months), but other types of menstrual disorders may also occur.<ref name=BMC2010 />
* [[Infertility]]: This generally results directly from chronic [[anovulation]] (lack of ovulation).<ref name=BMC2010 />
* [[hyperandrogenism|High levels of masculinizing hormones]]: Known as hyperandrogenism, the most common signs are [[acne]] and [[hirsutism]] (male pattern of hair growth, such as on the chin or chest), but it may produce [[hypermenorrhea]] (heavy and prolonged menstrual periods), [[androgenic alopecia]] (increased hair thinning or diffuse hair loss), or other symptoms.<ref name=BMC2010 /><ref name="AMN">{{cite web| vauthors = Cortet-Rudelli C, Dewailly D |title=Diagnosis of Hyperandrogenism in Female Adolescents|website=Hyperandrogenism in Adolescent Girls|url=http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-in-female/|date=21 September 2006|publisher=Armenian Health Network, Health.am|access-date=21 November 2006|url-status=live|archive-url=https://web.archive.org/web/20070930181313/http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-in-female/|archive-date=30 September 2007}}</ref> Approximately three-quarters of women with PCOS (by the diagnostic criteria of NIH/NICHD 1990) have evidence of [[hyperandrogenemia]].<ref name="huang">{{cite journal | vauthors = Huang A, Brennan K, Azziz R | title = Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria | journal = Fertility and Sterility | volume = 93 | issue = 6 | pages = 1938–41 | date = April 2010 | pmid = 19249030 | pmc = 2859983 | doi = 10.1016/j.fertnstert.2008.12.138 }}</ref>
* [[Metabolic syndrome]]: This appears as a tendency towards [[central obesity]] and other symptoms associated with [[insulin resistance]], including low energy levels and food cravings.<ref name=BMC2010 /> Serum [[insulin]], insulin resistance, and [[homocysteine]] levels are higher in women with PCOS.<ref name="FertSter_insulin">{{cite journal | vauthors = Nafiye Y, Sevtap K, Muammer D, Emre O, Senol K, Leyla M | title = The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome | journal = Fertility and Sterility | volume = 93 | issue = 6 | pages = 1864–9 | date = April 2010 | pmid = 19171332 | doi = 10.1016/j.fertnstert.2008.12.024 | doi-access = free }}</ref>
* [[Acne]]: A rise in testosterone levels increases the oil production within the sebaceous glands and clogs pores.<ref name=":0">{{cite book | vauthors = Pasquali R | chapter = Lifestyle Interventions and Natural and Assisted Reproduction in Patients with PCOS |date=2018 | title = Infertility in Women with Polycystic Ovary Syndrome |pages=169–180 |place=Cham |publisher=Springer International Publishing |doi=10.1007/978-3-319-45534-1_13 |isbn=978-3-319-45533-4}}</ref> For many women, the emotional impact is great and quality of life can be significantly reduced.<ref name=":1">{{cite journal |vauthors=Brutocao C, Zaiem F, Alsawas M, Morrow AS, Murad MH, Javed A |date=November 2018 |title=Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis |journal=Endocrine |volume=62 |issue=2 |pages=318–325 |doi=10.1007/s12020-018-1692-3 |pmid=30066285 |s2cid=51889051}}</ref>
* [[Androgenic alopecia]]: Estimates suggest that androgenic alopecia affects 22% of PCOS sufferers.<ref name=":0" /> This is a result of high testosterone levels that are converted into the dihydrotestosterone (DHT) hormone. Hair follicles become clogged, making hair fall out and preventing further growth.<ref>{{cite book | vauthors = Devi T | chapter = Lifestyle Modifications in Polycystic Ovarian Syndrome |date=2018 | title = Decoding Polycystic Ovarian Syndrome (PCOS) |pages=195 |publisher=Jaypee Brothers Medical Publishers (P) Ltd.|doi=10.5005/jp/books/13089_17 |isbn=978-93-86322-85-2 }}</ref>
* [[Acanthosis nigricans]] (AN): A skin condition where dark, thick, and "velvety" patches can form.<ref name=":2">{{Cite book | vauthors = Morrow-Baez K |title=Thriving with PCOS: Lifestyle Strategies to Successfully Manage Polycystic Ovary Syndrome |publisher=Rowman & Littlefield Publishers |year=2018}}</ref>
* Polycystic ovaries: There are small cysts on one or both ovaries. [[Ovary|Ovaries]] might enlarge and compress follicles surrounding the eggs. As a result, ovaries might fail to function regularly. This disease is related to the number of follicles per ovary each month, growing from the average range of 6–8 to double, triple, or more.{{Citation needed|date=May 2023}} Women with PCOS have a higher risk of multiple diseases including infertility, type 2 diabetes mellitus (DM-2), cardiovascular risk, metabolic syndrome, obesity, impaired glucose tolerance, depression, obstructive sleep apnea (OSA), endometrial cancer, and non-alcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH).<ref>{{cite book | vauthors = Rasquin LI, Anastasopoulou C, Mayrin JV | chapter = Polycystic Ovarian Disease | date = 2023 | pmid = 29083730 | url = https://www.ncbi.nlm.nih.gov/books/NBK459251/ | title = StatPearls | publisher = StatPearls Publishing | access-date = 1 September 2023 | archive-date = 8 May 2023 | archive-url = https://web.archive.org/web/20230508122900/https://www.ncbi.nlm.nih.gov/books/NBK459251/ | url-status = live }}</ref>

Women with PCOS tend to have central obesity. Still, studies are conflicting as to whether visceral and subcutaneous abdominal fat is increased, unchanged, or decreased in women with PCOS relative to non-PCOS women with the same [[body mass index]].<ref name="pmid25781555">{{cite journal | vauthors = Sam S | title = Adiposity and metabolic dysfunction in polycystic ovary syndrome | journal = Hormone Molecular Biology and Clinical Investigation | volume = 21 | issue = 2 | pages = 107–116 | date = February 2015 | pmid = 25781555 | doi = 10.1515/hmbci-2015-0008 | s2cid = 23592351 }}</ref> In any case, androgens, such as [[testosterone (medication)|testosterone]], [[androstanolone]] (dihydrotestosterone), and [[nandrolone decanoate]] have been found to increase visceral fat deposition in both female animals and women.<ref name="pmid18615851">{{cite journal | vauthors = Corbould A | title = Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome? | journal = Diabetes/Metabolism Research and Reviews | volume = 24 | issue = 7 | pages = 520–532 | date = October 2008 | pmid = 18615851 | doi = 10.1002/dmrr.872 | s2cid = 24630977 }}</ref>

Although 80% of PCOS presents in women with obesity, 20% of women diagnosed with the disease are non-obese or "lean" women.<ref>{{cite journal | vauthors = Goyal M, Dawood AS | title = Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review | journal = Journal of Human Reproductive Sciences | volume = 10 | issue = 3 | pages = 154–161 | date = 2017 | pmid = 29142442 | pmc = 5672719 | doi = 10.4103/jhrs.JHRS_77_17 | doi-access = free }}</ref> However, obese women who have PCOS have a higher risk of adverse outcomes, such as [[hypertension]], [[insulin resistance]], [[metabolic syndrome]], and [[endometrial hyperplasia]].<ref>{{cite journal | vauthors = Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S | title = Obese and Non-obese Polycystic Ovarian Syndrome: Comparison of Clinical, Metabolic, Hormonal Parameters, and their Differential Response to Clomiphene | journal = Indian Journal of Endocrinology and Metabolism | volume = 23 | issue = 2 | pages = 257–262 | date = 2019 | pmid = 31161114 | pmc = 6540884 | doi = 10.4103/ijem.IJEM_637_18 | doi-access = free }}</ref>

Even though most women with PCOS are overweight or obese, it is important to acknowledge that non-overweight women can also be diagnosed with PCOS. Up to 30% of women diagnosed with PCOS maintain a normal weight before and after diagnosis. "Lean" women still face the various symptoms of PCOS with the added challenges of having their symptoms properly addressed and recognized. Lean women often go undiagnosed for years and are usually diagnosed after struggles to conceive.<ref>{{Cite journal| vauthors = Johnstone E, Cannon-Albright L, Peterson CM, Allen-Brady K |title=Lean PCOS may be a genetically distinct from obese PCOS: lean women with polycystic ovary syndrome and their relatives have no increased risk of T2DM | journal = Human Reproduction | date = July 2018 | volume = 33 | pages = 454| location = Oxford, England | publisher = Oxford Univ Press | doi = 10.26226/morressier.5af300b3738ab10027aa99cd|s2cid=242055977}}</ref> Lean women are likely to have a missed diagnosis of diabetes and cardiovascular disease. These women also have an increased risk of developing insulin resistance, despite not being overweight. Lean women are often taken less seriously with their diagnosis of PCOS and also face challenges finding appropriate treatment options. This is because most treatment options are limited to approaches for losing weight and healthy dieting.<ref>{{cite journal | vauthors = Goyal M, Dawood AS | title = Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review | journal = Journal of Human Reproductive Sciences | volume = 10 | issue = 3 | pages = 154–161 | date = 2017 | pmid = 29142442 | pmc = 5672719 | doi = 10.4103/jhrs.jhrs_77_17 | doi-access = free }}</ref>

=== Hormone levels ===
[[Testosterone]] levels are usually elevated in women with PCOS.<ref name="MazzeStrockSimonson2007" /><ref name="pmid32462512">{{cite journal | vauthors = Loh HH, Yee A, Loh HS, Kanagasundram S, Francis B, Lim LL | title = Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis | journal = Hormones (Athens) | volume = 19 | issue = 3 | pages = 413–423 | date = September 2020 | pmid = 32462512 | doi = 10.1007/s42000-020-00210-0 | s2cid = 218898082 | url = | quote = A total of 5366 women with PCOS from 21 studies were included. [...] Women with PCOS [...] [had higher] serum total testosterone level (2.34 ± 0.58 nmol/L vs 1.57 ± 0.60 nmol/L, p < 0.001) compared with women without PCOS. [...] PCOS is characterized by high levels of androgens (dehydroepiandrosterone, androstenedione, and testosterone) and luteinizing hormone (LH), and increased LH/follicle-stimulating hormone (FSH) ratio [52].}}</ref> In a 2020 [[systematic review]] and [[meta-analysis]] of sexual dysfunction related to PCOS which included 5,366&nbsp;women with PCOS from 21&nbsp;studies, testosterone levels were analyzed and were found to be 2.34&nbsp;nmol/L (67&nbsp;ng/dL) in women with PCOS and 1.57&nbsp;nmol/L (45&nbsp;ng/dL) in women without PCOS.<ref name="pmid32462512" /> In a 1995 study of 1,741&nbsp;women with PCOS, mean testosterone levels were 2.6&nbsp;(1.1–4.8) nmol/L (75&nbsp;(32–140)&nbsp;ng/dL).<ref name="pmid8567849">{{cite journal | vauthors = Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ, West C, Jacobs HS | title = Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients | journal = Hum Reprod | volume = 10 | issue = 8 | pages = 2107–11 | date = August 1995 | pmid = 8567849 | doi = 10.1093/oxfordjournals.humrep.a136243 | url = | quote = The criteria for the diagnosis of the polycystic ovary syndrome (PCOS) have still not been agreed universally. A population of 1741 women with PCOS were studied, all of whom had polycystic ovaries seen by ultrasound scan. The frequency distributions of the serum concentrations of [...] testosterone [...] were determined and compared with the symptoms and signs of PCOS. [...] A rising serum concentration of testosterone [mean and 95th percentiles 2.6 (1.1-4.8) nmol/1] was associated with an increased risk of hirsutism, infertility, and cycle disturbance. [...] If the serum testosterone concentration is >4.8 nmol/1, other causes of hyperandrogenism should be excluded.}}</ref> In a 1998 study which reviewed many studies and subjected them to meta-analysis, testosterone levels in women with PCOS were 62 to 71&nbsp;ng/dL (2.2–2.5&nbsp;nmol/L) and testosterone levels in women without PCOS were about 32&nbsp;ng/dL (1.1&nbsp;nmol/L).<ref name="pmid15251757">{{cite journal | vauthors = Steinberger E, Ayala C, Hsi B, Smith KD, Rodriguez-Rigau LJ, Weidman ER, Reimondo GG | title = Utilization of commercial laboratory results in management of hyperandrogenism in women | journal = Endocr Pract | volume = 4 | issue = 1 | pages = 1–10 | date = 1998 | pmid = 15251757 | doi = 10.4158/EP.4.1.1 | url = }}</ref> In a 2010 study of 596 women with PCOS which used [[liquid chromatography–mass spectrometry]] (LC–MS) to quantify testosterone, median levels of testosterone were 41 and 47&nbsp;ng/dL (with 25th–75th percentiles of 34–65&nbsp;ng/dL and 27–58&nbsp;ng/dL and ranges of 12–184&nbsp;ng/dL and 1–205&nbsp;ng/dL) via two different labs.<ref name="pmid20826578">{{cite journal | vauthors = Legro RS, Schlaff WD, Diamond MP, Coutifaris C, Casson PR, Brzyski RG, Christman GM, Trussell JC, Krawetz SA, Snyder PJ, Ohl D, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Santoro N, Eisenberg E, Zhang M, Zhang H | title = Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism | journal = J Clin Endocrinol Metab | volume = 95 | issue = 12 | pages = 5305–13 | date = December 2010 | pmid = 20826578 | pmc = 2999971 | doi = 10.1210/jc.2010-1123 | url = | quote = Design and Setting: We conducted a blinded laboratory study including masked duplicate samples at three laboratories—two academic (University of Virginia, RIA; and Mayo Clinic, LC/MS) and one commercial (Quest, LC/MS). Participants and Interventions: Baseline testosterone levels from 596 women with PCOS who participated in a large, multicenter, randomized controlled infertility trial performed at academic health centers in the United States were run by varying assays, and results were compared. [...] The median testosterone level by RIA was 50 ng/dl (25th–75th percentile, 34–71 ng/dl); by LC/MS at Mayo, 47 ng/dl (25th–75th percentile, 34–65 ng/dl); and by LC/MS at Quest, 41 ng/dl (25th–75th percentile, 27–58 ng/dl) (Fig. 1). The minimum and maximum values detected by RIA were 8 and 189 ng/dl, respectively; by LC/MS at Mayo, 12 and 184 ng/dl, respectively; and by LC/MS at Quest, 1 and 205 ng/dl, respectively. [...] Our sample size was robust and the largest study to date examining quality control of total testosterone serum levels in women.}}</ref> If testosterone levels are above 100 to 200&nbsp;ng/dL, per different sources, other possible causes of [[hyperandrogenism]], such as [[congenital adrenal hyperplasia]] or an [[androgen]]-secreting [[tumor]], may be present and should be excluded.<ref name="pmid8567849" /><ref name="CarminaStanczykLobo2019">{{cite book | vauthors =  Carmina E, Stanczyk FZ, Lobo RA  | chapter = Evaluation of Hormonal Status | veditors = Strauss JF, Barbieri RL | title = Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management | edition = 8th | date = 2019 | pages = 887–915.e4 | publisher = Elsevier | doi = 10.1016/B978-0-323-47912-7.00034-2 | isbn = 978-0-323-47912-7 | s2cid = 56977185 | url = }}</ref><ref name="MazzeStrockSimonson2007">{{cite book | vauthors = Mazze R, Strock ES, Simonson GD, Bergenstal RM | chapter = Type 2 Diabetes and Metabolic Syndrome in Children and Adolescents | date = 11 January 2007 | title = Staged Diabetes Management: A Systematic Approach | edition = 2nd | publisher = John Wiley & Sons | pages = 213– | isbn = 978-0-470-06171-8 | oclc = 1039172275 | chapter-url = https://books.google.com/books?id=dQVfgd71NWEC&pg=PA213 | quote = Diagnosis and treatment. The first diagnostic test [of PCOS] is a measurement of total testosterone and free testosterone by radioimmunoassay. If total testosterone is between 50 ng/dL and 200 ng/dL above normal (<2.5 ng/dL), PCOS is present. If >200 ng/dL, then serum DHEA-S should be measured. If total testosterone or DHEA-S >700 μg/dL, then rule out an ovarian or adrenal tumor. These tests should be followed by tests for hypothyroidism, hyperprolactinemia, and adrenal hyperplasia. | access-date = 18 September 2022 | archive-date = 29 May 2024 | archive-url = https://web.archive.org/web/20240529161111/https://books.google.com/books?id=dQVfgd71NWEC&pg=PA213#v=onepage&q&f=false | url-status = live }}</ref>

=== Associated conditions ===
Warning signs may include a change in appearance. But there are also manifestations of mental health problems, such as anxiety, depression, and eating disorders.<ref name="vice.com" />{{Medical citation needed|date=July 2022}}

A diagnosis of PCOS suggests an increased risk of the following:
* [[Endometrial hyperplasia]] and [[endometrial cancer]] (cancer of the uterine lining) are possible, due to overaccumulation of the uterine lining, and also lack of [[progesterone]], resulting in prolonged stimulation of uterine cells by estrogen.<ref name="emedicine_main" /><ref name="BarryAzizia2014" /> It is not clear whether this risk is directly due to the syndrome or from the associated obesity, [[hyperinsulinemia]], and [[hyperandrogenism]].<ref>{{cite journal |vauthors=New MI |title=Nonclassical congenital adrenal hyperplasia and the polycystic ovarian syndrome |journal=Annals of the New York Academy of Sciences |volume=687 |issue=1 |pages=193–205 |date=May 1993 |pmid=8323173 |doi=10.1111/j.1749-6632.1993.tb43866.x |s2cid=30161989 |bibcode=1993NYASA.687..193N }}</ref><ref name="pmid12781553">{{cite journal | vauthors = Hardiman P, Pillay OC, Atiomo W | title = Polycystic ovary syndrome and endometrial carcinoma | journal = Lancet | volume = 361 | issue = 9371 | pages = 1810–2 | date = May 2003 | pmid = 12781553 | doi = 10.1016/S0140-6736(03)13409-5 | s2cid = 27453081 }}</ref><ref>{{cite journal | vauthors = Mather KJ, Kwan F, Corenblum B | title = Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity | journal = Fertility and Sterility | volume = 73 | issue = 1 | pages = 150–6 | date = January 2000 | pmid = 10632431 | doi = 10.1016/S0015-0282(99)00468-9 | doi-access = free }}</ref>
* [[Insulin resistance]]/[[type 2 diabetes]]. A review published in 2010 concluded that women with PCOS have an elevated prevalence of insulin resistance and type 2 diabetes, even when controlling for [[body mass index]] (BMI).<ref name=emedicine_main /><ref>{{cite journal | vauthors = Moran LJ, Misso ML, Wild RA, Norman RJ | title = Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis | journal = Human Reproduction Update | volume = 16 | issue = 4 | pages = 347–363 |date= 2010 | pmid = 20159883 | doi = 10.1093/humupd/dmq001 | doi-access = free }}</ref> PCOS is also associated with higher risk for diabetes.<ref>{{cite book |vauthors=Falcone T, Hurd RW |title=Clinical Reproductive Medicine and Surgery |date=2007 |publisher=Elsevier Health Sciences |isbn=978-0-323-03309-1 |page=223 |url=https://books.google.com/books?id=fOPtaEIKvcIC&pg=PA223 |language=en |access-date=24 May 2020 |archive-date=14 January 2023 |archive-url=https://web.archive.org/web/20230114012631/https://books.google.com/books?id=fOPtaEIKvcIC&pg=PA223 |url-status=live }}</ref>
* [[High blood pressure]], in particular if obese or during pregnancy<ref>{{cite web |title=Polycystic ovary syndrome (PCOS) - Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439 |website=Mayo Clinic |access-date=26 June 2021 |archive-date=21 November 2021 |archive-url=https://web.archive.org/web/20211121111442/https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439 |url-status=live }}</ref>
* [[Depression (mood)|Depression]] and [[anxiety (mood)|anxiety]]<ref name=BMC2010 /><ref>{{cite journal | vauthors = Barry JA, Kuczmierczyk AR, Hardiman PJ | title = Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis | journal = Human Reproduction | volume = 26 | issue = 9 | pages = 2442–51 | date = September 2011 | pmid = 21725075 | doi = 10.1093/humrep/der197 | doi-access = free }}</ref>
* [[Dyslipidemia]]&nbsp;– disorders of lipid metabolism&nbsp;– cholesterol and triglycerides. Women with PCOS show a decreased removal of [[atherosclerosis]]-inducing remnants, seemingly independent of insulin resistance/type 2 diabetes.<ref>{{cite journal | vauthors = Ovalle F, Azziz R | title = Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus | journal = Fertility and Sterility | volume = 77 | issue = 6 | pages = 1095–1105 | date = June 2002 | pmid = 12057712 | doi = 10.1016/s0015-0282(02)03111-4 | doi-access = free }}</ref>
* [[Cardiovascular disease]],<ref name=emedicine_main /> with a meta-analysis estimating a 2-fold risk of arterial disease for women with PCOS relative to women without PCOS, independent of BMI.<ref>{{cite journal | vauthors = de Groot PC, Dekkers OM, Romijn JA, Dieben SW, Helmerhorst FM | title = PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis | journal = Human Reproduction Update | volume = 17 | issue = 4 | pages = 495–500 | date = 1 July 2011 | pmid = 21335359 | doi = 10.1093/humupd/dmr001 | doi-access = free }}</ref>
* [[Stroke]]s<ref name=emedicine_main />
* [[Weight gain]]{{citation needed|date=May 2024}}
* [[Miscarriage]]<ref name="pmid18277353">{{cite journal | vauthors = Goldenberg N, Glueck C | title = Medical therapy in women with polycystic ovarian syndrome before and during pregnancy and lactation | journal = Minerva Ginecologica | volume = 60 | issue = 1 | pages = 63–75 | date = February 2008 | pmid = 18277353 | url = https://www.minervamedica.it/en/journals/minerva-obstetrics-gynecology/article.php?cod=R09Y2008N01A0063 | access-date = 13 October 2021 | archive-date = 2 November 2021 | archive-url = https://web.archive.org/web/20211102082813/https://www.minervamedica.it/en/journals/minerva-obstetrics-gynecology/article.php?cod=R09Y2008N01A0063 | url-status = live }}</ref><ref name="pmid18181085">{{cite journal | vauthors = Boomsma CM, Fauser BC, Macklon NS | title = Pregnancy complications in women with polycystic ovary syndrome | journal = Seminars in Reproductive Medicine | volume = 26 | issue = 1 | pages = 72–84 | date = January 2008 | pmid = 18181085 | doi = 10.1055/s-2007-992927 | s2cid = 260316768 }}</ref>
* [[Sleep apnea]], particularly if obesity is present{{citation needed|date=May 2024}}
* [[Non-alcoholic fatty liver disease]], particularly if obesity is present{{citation needed|date=May 2024}}
* [[Acanthosis nigricans]] (patches of darkened skin under the arms, in the groin area, on the back of the neck)<ref name=emedicine_main />
* [[Autoimmune thyroiditis]]{{citation needed|date=June 2018}}
* [[Iron deficiency]]<ref>{{Cite web |title=Iron Deficiency Injectables Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast 2020-2025 |url=https://www.imarcgroup.com/iron-deficiency-injectables-market |access-date=2 August 2023 |website=imarc |archive-date=2 August 2023 |archive-url=https://web.archive.org/web/20230802112545/https://www.imarcgroup.com/iron-deficiency-injectables-market |url-status=live }}</ref>{{better source needed|date=September 2024}}
The risk of [[ovarian cancer]] and [[breast cancer]] is not significantly increased overall, but women with PCOS were about three times more likely to develop [[endometrial cancer]] than other women.<ref name="BarryAzizia2014">{{cite journal | vauthors = Barry JA, Azizia MM, Hardiman PJ | title = Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis | journal = Human Reproduction Update | volume = 20 | issue = 5 | pages = 748–758 | date = 1 September 2014 | pmid = 24688118 | pmc = 4326303 | doi = 10.1093/humupd/dmu012 }}</ref>

Some medical providers and groups consider PCOS to be an [[intersex]] condition because some sex hormones are outside the typical range.<ref>Tara Becker, Marshall Chin, and Nancy Bates (9 Mar 2022). [http://www.ncbi.nlm.nih.gov/books/NBK581039/ "Measuring Sex, Gender Identity, and Sexual Orientation".] ''National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Committee on National Statistics; Committee on Measuring Sex, Gender Identity, and Sexual Orientation''. Washington DC: National Academies Press (US). 7, Measuring Intersex/DSD Populations. [https://web.archive.org/web/20250201221206/https://www.ncbi.nlm.nih.gov/books/NBK581039/ Archived] from the original on 1 February 2025. Retrieved 12 February 2025.</ref> However, medical consensus, including the Endocrine Society and NIH, defines PCOS as an endocrine/metabolic disorder, not intersex, as it lacks congenital sex characteristic variations.<ref>{{Cite journal |last1=Singh |first1=Samradhi |last2=Pal |first2=Namrata |last3=Shubham |first3=Swasti |last4=Sarma |first4=Devojit Kumar |last5=Verma |first5=Vinod |last6=Marotta |first6=Francesco |last7=Kumar |first7=Manoj |date=11 February 2023 |title=Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics |journal=Journal of Clinical Medicine |language=en |volume=12 |issue=4 |pages=1454 |doi=10.3390/jcm12041454 |doi-access=free |pmid=36835989 |pmc=9964744 |issn=2077-0383 }}</ref><ref>{{Cite web |date=24 January 2022 |title=Polycystic Ovary Syndrome |url=https://www.endocrine.org/patient-engagement/endocrine-library/pcos |access-date=7 March 2025 |website=www.endocrine.org |language=en}}</ref> A 2023 study notes two transmasculine individuals self-identified as intersex without medical diagnosis, tying it to identity, not biology.<ref>{{Cite journal |last1=Wugalter |first1=Katrina |last2=Perovic |first2=Mateja |last3=Karkaby |first3=Laurice |last4=Einstein |first4=Gillian |date=2 April 2024 |title=The double-edged sword of PCOS and gender: exploring gender-diverse experiences of polycystic ovary syndrome |journal=International Journal of Transgender Health |language=en |volume=25 |issue=2 |pages=251–267 |doi=10.1080/26895269.2023.2183448 |pmid=38681493 |pmc=11044764 |issn=2689-5269}}</ref>