Polycystic ovary syndrome (PCOS), a hormonal imbalance affecting ovaries, menstrual cycles, and fertility, impacts approximately one in 10 women in Canada.
Unlike ovarian cysts, PCOS is linked to infertility, pregnancy complications, heart disease, and a reduced quality of life—yet less than half of those affected know they have it.
This under-recognition and under-diagnosis present a major issue: a recent Canadian study indicates that women with PCOS face a 20 to 40 percent higher risk of lifelong negative health outcomes compared to the general population.
These include hypertension (high blood pressure), kidney disease, gastrointestinal disorders, eating disorders, and mental health conditions like depression and anxiety.
The researchers also found that obesity, dyslipidemia (abnormal blood fat levels), and Type 2 diabetes are two to three times more common in women with PCOS. Most critically, cardiovascular disease—which causes heart failure and stroke—is 30 to 50 percent more likely in this group and occurs three to four years earlier than average.
As cardiovascular disease is the leading cause of death globally, missed or untreated PCOS symptoms put women’s health at serious risk.
Personal and Systemic Costs
The personal toll of PCOS is substantial, affecting both physical and mental well-being. It also imposes significant financial, healthcare, and work-life burdens—disproportionately impacting women in lower socioeconomic groups.
These challenges are exacerbated by systemic failures in diagnosis and management. Women report that doctors often dismiss their concerns, doubt their symptoms, or struggle to make a definitive diagnosis. An international survey found that diagnosis can take months, even years.
Variable Symptoms, Manageable with Care
PCOS symptoms vary among individuals, but discussing potential signs with a doctor is crucial: early management can help prevent serious related health issues. Common symptoms include:
- Irregular menstrual periods
- Hirsutism (excess body hair, typically darker hair on the face, arms, chest, or abdomen)
- Hair thinning or loss (caused by high levels of male hormones, or androgens)
- Acne and/or oily skin
- Weight gain
- Diagnosis and Management
Nearly a century after its first diagnosis, PCOS has no single confirmatory test and no cure. If a doctor suspects PCOS, they may order blood work to check hormone levels and an ultrasound to examine the ovaries. Unlike ovarian cysts—fluid-filled sacs that can cause pain—polycystic ovaries are enlarged with multiple visible follicles on ultrasound.
Upon diagnosis, further testing for cholesterol and glucose levels is typically recommended to manage heart disease and diabetes risks.
Researchers advise women with PCOS to adopt lifestyle strategies to manage their condition:
- Eating a healthy diet
- Exercising regularly (including strength training)
- Sleeping at least seven hours nightly
- Reducing stress (e.g., through work-life balance, deep breathing)
- Engaging in relaxing activities (yoga, mindfulness, hobbies)
- Advances in Research and Advocacy
Despite current gaps, progress is underway. In recent years, global efforts have focused on advocating for women with PCOS and advancing research.
In 2023, an international PCOS guideline, led by Australian researchers, was published. It recommends personalized treatment approaches, including lifestyle modifications (e.g., healthy eating, exercise), medical symptom management, and regular checkups to screen for complications.
In Canada, Alberta recently launched a clinical pathway to improve PCOS recognition, treatment, and advocacy—with potential for broader adoption.
At the University of Calgary, Dr. Jamie Benham leads EMBRACE (Endocrine, Metabolic and Reproductive Advancements), a new women’s health research lab focusing on reproductive disorders across women’s lifespans, including PCOS and gestational diabetes. The lab is conducting an online needs-assessment survey and plans focus groups later this year to co-design a patient tool for PCOS management.
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