Polycystic ovary syndrome (PCOS) is a lifelong disease. It is most often diagnosed in adolescents and young women who present with symptoms of hyperandrogenism and/or disorders of ovulation. From that moment, the individuals and their doctors must be aware that PCOS carries various long-term health risks owing to its intrinsic hormonal derangement and also to the associated metabolic disorders such as obesity, hyperinsulinism and insulin resistance, hyperlipidaemia and pancreatic β-cell dysfunction. The pubertal onset of PCOS thus provides a unique opportunity to detect these risks early and to engage preventive measures.

Although many intermediary risk factors are present in most women with PCOS, the risks for the occurrence of clinical events are difficult to quantify precisely in the absence of large-scale prospective studies. The few available epidemiological studies are difficult to compare with each other and are not conclusive because different definitions for PCOS have been used, series were sometimes small and some included individuals who were too young to be exposed to the events predicted by the risk factors.

Increased cardiovascular risk

The increased cardiovascular risk in women with PCOS has been extensively discussed in the recent literature, as reviewed by Rizzo et al. While there is no doubt that many cardiovascular risk factors are present to various degrees in women with PCOS, a clear-cut demonstration of an increased prevalence of cardiovascular events in comparison with age-matched women without PCOS is still awaited.