Çelik Özlem, Köse Mehmet Faruk
Department of Internal Medicine, Division of Endocrinology and Metabolism, Acıbadem University Faculty of Medicine, İstanbul, Turkey
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Acıbadem University Faculty of Medicine, İstanbul, Turkey
J Turk Ger Gynecol Assoc. 2021 Dec 6;22(4):326-333. doi: 10.4274/jtgga.galenos.2021.2021.0077.
The manifestations of polycystic ovary syndrome (PCOS), a ubiquitous reproductive disorder, may vary significantly depending on the severity of a number of endocrine and metabolic changes. Although no diagnostic criteria are presently available for PCOS for perimenopausal and menopausal women, the condition can still be suspected in case of a previous diagnosis of the condition, a chronic history of irregular menstrual cycles and hyperandrogenism, and/or polycystic ovarian morphology during the reproductive period. PCOS is associated with long-term health risks, including obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome and cardiovascular risk factors during reproductive age, especially in patients possessing classic phenotypes. The aim of this review was to outline the available data about the impact of PCOS on long-term health risks after reproductive age in patients with PCOS. Previously, it was assumed that women with PCOS would be more prone to develop cardiometabolic diseases after reproductive age but current data suggest that in accordance with the healing in the phenotypic characteristics of PCOS, no deterioration appears to occur in cardiometabolic health in these patients. While there is substantial evidence for a greater prevalence of abnormal subclinical atherosclerotic markers among younger patients with PCOS, data for older women are insufficient. However, there is also support for an increased risk of endometrial cancer in PCOS patients. Extensive prospective cohort studies in which healthy controls as well as patients with defining PCOS phenotypes are observed and monitored from the early reproductive period into the late postmenopausal period should now be performed in order to clarify morbidities and mortality in aging women with PCOS.
多囊卵巢综合征(PCOS)是一种常见的生殖系统疾病,其表现可能因多种内分泌和代谢变化的严重程度而有显著差异。尽管目前尚无针对围绝经期和绝经后女性PCOS的诊断标准,但如果既往有该疾病诊断、月经周期不规则和高雄激素血症的慢性病史,和/或生育期出现多囊卵巢形态,仍可怀疑患有此病。PCOS与长期健康风险相关,包括肥胖、糖尿病、高血压、血脂异常、代谢综合征以及生育年龄期间的心血管危险因素,尤其是具有典型表型的患者。本综述的目的是概述有关PCOS对PCOS患者生育年龄后长期健康风险影响的现有数据。以前,人们认为患有PCOS的女性在生育年龄后更容易患心脏代谢疾病,但目前的数据表明,随着PCOS表型特征的缓解,这些患者的心脏代谢健康似乎没有恶化。虽然有大量证据表明年轻PCOS患者中异常亚临床动脉粥样硬化标志物的患病率更高,但老年女性的数据不足。然而,也有证据支持PCOS患者患子宫内膜癌的风险增加。现在应该进行广泛的前瞻性队列研究,从生育早期到绝经后期观察和监测健康对照以及具有明确PCOS表型的患者,以阐明老年PCOS女性的发病率和死亡率。