Polycystic Ovary Syndrome (PCOS) affects millions of women worldwide and is a leading cause of reproductive, metabolic, and cardiovascular health problems.
A long-term prospective study from the Endocrinology Clinic at McGill University revealed how one of the key criteria for PCOS—Polycystic Ovary Morphology (PCOM), which is characterized on ultrasound by the presence of 12 or more small follicles (2–9 mm)—can predict an increased risk of chronic diseases in the long term. This data fundamentally deepens the understanding of different PCOS phenotypes and facilitates the development of therapeutic strategies tailored to individual needs.
Study Details:
This prospective cohort study observed 340 women with PCOS over a period of 37 years. Participants were divided into two groups: those with PCOM (189 women) and those without PCOM (151 women) who, although they did not show classic polycystic ovaries on ultrasound, met the other conditions of the Rotterdam criteria (oligo/amenorrhea and/or chronic anovulation; clinically or biochemically confirmed hyperandrogenism).
At the baseline assessment of the study, women with PCOM were younger, but they showed significantly worsened metabolic indicators. This included a higher body mass index, insulin resistance, high cholesterol, triglycerides, and elevated androgen levels.
This metabolic dysfunction increases the risk of developing pathologies such as Type 2 Diabetes and neurodegenerative diseases (e.g., non-insulin-dependent diabetes-related neurodegenerative disorders – NIDD). In fact, individuals in the PCOM group had an almost three times higher probability of developing NIDD later in life compared to women without PCOM.
Although PCOM was associated with increased metabolic and neurodegenerative risks, no statistically significant difference was found between the groups in other chronic diseases (including cardiovascular pathologies or mortality rates) over the long period of the study. This indicates that PCOM allows us to early identify a subgroup of women with PCOS who have the most severe metabolic health problems. However, it may not be an equal indicator of all long-term outcomes, which further confirms the heterogeneous nature of PCOS.
This research, which stands out with one of the longest observation periods in PCOS studies, provides solid evidence that ovary morphology is an important marker for assessing long-term metabolic risks. The paper integrates detailed baseline hormonal and metabolic profiles with decades of general health data. Therefore, the initiation of targeted early interventions in PCOM-positive women is essential to reduce the risk of future complications.
Source: JAMA
