PCOS and Your Health: Risks, Diagnosis and Treatment in Singapore

Polycystic ovary syndrome or PCOS is one of the most common hormonal conditions in women, yet its implications extend well beyond irregular periods and skin changes. For women who want to manage their health, understanding what PCOS means for long-term health is one of the most empowering things they can do. PCOS is manageable, and with the right support, its associated risks can be significantly reduced. This article covers what those risks are, how PCOS is diagnosed, and what treatment looks like in Singapore. 

Key Takeaways

• PCOS is associated with an increased risk of Type 2 diabetes, heart disease, endometrial cancer and mental health conditions — but these risks are not inevitable.
• Insulin resistance is central to many of the long-term health risks of PCOS and can be present even in women of normal body weight
• A GP can diagnose PCOS and prescribe first-line treatment — most women do not need to go straight to a specialist
• PCOS is diagnosed through a combination of clinical history, blood tests and, in some cases, a pelvic ultrasound
• A woman does not need polycystic ovaries on ultrasound to receive a PCOS diagnosis
• Early diagnosis and management significantly improve long-term health outcomes

Why the Long-term Risks of PCOS Matter

PCOS is often first noticed through its more visible signs — irregular periods, acne, and excess hair growth. But the hormonal and metabolic disruptions driving those symptoms do not stop there.

Over time, the same imbalances that affect the ovaries also affect the body's ability to regulate blood sugar, protect the heart, maintain the uterine lining and support mental health. This is why PCOS is now recognised not just as a reproductive condition, but as a chronic metabolic one that requires long-term attention.¹

Each of the risks below can be managed, and all of them are easier to address when caught early.

What are the Long-term Risks of PCOS?

PCOS affects different systems of the body in different ways. The risks below are not experienced by every woman with PCOS, and their severity varies. What they share is a common root: the hormonal and metabolic imbalances that define the condition. This is why managing PCOS early and consistently makes a meaningful difference.

Diabetes and metabolic health

Insulin resistance is closely associated with PCOS and is present in the majority of women with the condition, regardless of body weight. When cells do not respond normally to insulin, the pancreas produces more of it to compensate. Over time, this places significant strain on the body's ability to regulate blood sugar, raising the risk of pre-diabetes and Type 2 diabetes.¹

Women with PCOS are at significantly higher risk of developing Type 2 diabetes compared to women without the condition, including those of normal weight.¹ If poorly controlled, diabetes increases the risk of serious complications including kidney disease, nerve damage, vision problems and cardiovascular disease.

What you can do

Insulin resistance responds well to lifestyle changes, particularly a low-glycaemic index diet and regular exercise. Where appropriate, medication can help improve insulin sensitivity. A fasting glucose and HbA1c test are recommended for all women with PCOS at their next GP check-up, regardless of weight or current symptoms.

Heart disease

Insulin resistance does not only affect blood sugar. The same metabolic disruption also places strain on the heart and blood vessels. Elevated androgens, insulin resistance, abnormal cholesterol levels and chronic low-grade inflammation all contribute to a higher risk of high blood pressure, arterial disease, heart attack and stroke over time.

PCOS is now formally recognised as a cardiovascular disease risk-enhancing factor.⁷ This risk is present even in younger women during their reproductive years, making it one of the less obvious but more significant long-term implications of PCOS. Many women with PCOS are unaware of their cardiovascular risk until routine blood tests flag it.

What you can do

Regular blood pressure and cholesterol monitoring are the most important first steps. A lipid profile should be included as part of PCOS health check. If results indicate elevated cholesterol or blood pressure, a GP can arrange further monitoring or treatment. Lifestyle changes including regular exercise, a heart-healthy diet and stress management all meaningfully reduce cardiovascular risk over time.

Endometrial cancer

Women with PCOS who have infrequent or absent periods face a specific risk related to the uterine lining. When the lining builds up month after month without being shed, prolonged oestrogen exposure can lead to endometrial hyperplasia, a thickening of the lining that may progress to endometrial cancer if unaddressed. Research shows women with PCOS have approximately two to three times the risk of endometrial cancer compared to women without the condition.⁶

It is important to keep this in perspective. The overall incidence of endometrial cancer in the general population is relatively low, and this increased relative risk should be understood in that context. The risk is most significant in women who consistently have fewer than four periods per year.⁶

What you can do

Ensuring the uterine lining sheds regularly is the most effective way to reduce this risk. The combined oral contraceptive pill provides this protection for women who are not trying to conceive. 5 Women with fewer than four periods per year should raise this with their GP, it has direct implications for endometrial health beyond cycle regularity.

Mental health

Women with PCOS experience substantially higher rates of depression and anxiety than women without the condition.³ These are not simply a reaction to living with a chronic illness. The hormonal and metabolic changes associated with PCOS, including elevated androgens and insulin resistance, can influence mood and emotional wellbeing. Disrupted sleep, body image concerns and the social stigma around symptoms such as excess hair growth and weight changes all contribute further.

The psychological burden of PCOS is one of the most under-recognised aspects of the condition. Many women manage symptoms like acne, weight gain or hair changes for years without anyone connecting them to their emotional health or asking about it.

What you can do

Mental health screening should be a routine part of PCOS management, not an afterthought. Persistent low mood, anxiety or changes in how a woman feels about her body are worth raising at any GP consultation. A GP can provide initial support and refer to a psychologist or psychiatrist where needed.

Fertility and pregnancy

PCOS is the most common cause of ovulatory infertility worldwide.² Because PCOS can disrupt or prevent regular ovulation, conceiving naturally may take longer. For many women, difficulty conceiving is the moment at which PCOS is first suspected or diagnosed.

However, PCOS does not mean infertility. Many women with the condition conceive naturally, particularly when lifestyle changes help restore more regular ovulation. For those who need support, effective treatments are available. Local research involving 1,249 Asian women who underwent IVF at NUH found that women with PCOS achieved higher cumulative pregnancy rates than women without, with particularly strong outcomes in women aged 36 and above.⁴

What you can do

A GP is the right starting point for any fertility concern related to PCOS. They can assess ovulation patterns, arrange relevant tests and refer to a gynaecologist or fertility specialist, when appropriate. Women who are trying to conceive and have not succeeded after six to twelve months should speak to their doctor.

Managing PCOS starts with the right support. If you are experiencing any of the PCOS symptoms, speak to a Healthway Medical GP to assess your symptoms, understand your risks and build a plan that works for you.

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How is PCOS Diagnosed?

PCOS is diagnosed through a combination of clinical history, physical examination and investigations. There is no single definitive test. Instead, GPs use what is known as the Rotterdam criteria⁸, which require at least two of the following three features to be present, once other conditions have been ruled out:

• irregular or infrequent periods,
• clinical or biochemical signs of elevated androgens,
• and polycystic ovarian morphology on ultrasound.⁵

All three features do not need to be present for the diagnosis.

What your GP will look for

A GP will begin with a detailed consultation covering menstrual history, symptom onset, family history of PCOS or Type 2 diabetes, and any concerns about fertility or weight. A physical examination follows, typically checking blood pressure, BMI, skin for signs of acanthosis nigricans, dark velvety patches that can indicate insulin resistance, and any visible signs of androgen excess such as hirsutism.

Alongside the consultation, a GP might arrange blood tests to build a clearer picture of hormonal and metabolic health.

Blood tests and what they measure

Blood tests serve two purposes: supporting the diagnosis and establishing a metabolic baseline to identify associated risks. Tests typically include:

• Female hormonal panel. FSH, LH, oestradiol, prolactin and testosterone — these assess hormone levels and help identify androgen excess.
• Anti-Müllerian hormone (AMH). Measures ovarian reserve. Elevated AMH is associated with PCOS and polycystic ovarian morphology.⁵
• Fasting glucose and HbA1c. Screens for insulin resistance, pre-diabetes and Type 2 diabetes. Recommended for all women with suspected PCOS regardless of weight.⁵
• Lipid profile. Assesses cholesterol and triglyceride levels to evaluate cardiovascular risk.
• Thyroid function tests. Hypothyroidism can mimic several PCOS symptoms including irregular periods, weight gain and fatigue. Ruling it out is an important part of the diagnostic process.

A pelvic ultrasound may also be recommended, though it is not always required for a diagnosis.

Pelvic ultrasound

A pelvic ultrasound examines the ovaries for polycystic morphology (small, underdeveloped follicles associated with PCOS) and evaluates the uterine lining. It is a supporting tool, not a requirement for diagnosis. Many women with PCOS do not show a polycystic pattern on ultrasound, and some women without PCOS do. Findings are always interpreted alongside symptoms and blood results.

Getting tested does not have to be complicated. Regardless of the stage of their PCOS journey, most women benefit from regular monitoring. Catching changes in blood glucose, cholesterol or hormonal levels early means more options and better outcomes. Healthway Health Screening offers ongoing health screening programmes suited to women managing long-term conditions.

How is PCOS Managed?

Once a diagnosis is confirmed, the focus shifts to management. PCOS treatment is tailored to each woman's symptoms and goals, including whether she is trying to conceive. The focus is on managing symptoms, protecting long-term health and supporting fertility where relevant. Treatment typically involves a combination of lifestyle changes and medication prescribed by a GP.

When to see a specialist

For most women, a GP is the right starting point and can manage PCOS comprehensively over time. In some cases, however, the complexity of symptoms or specific goals such as fertility treatment may benefit from specialist input. A GP will advise on whether and when a referral is appropriate.

A referral to a specialist is typically considered in the following situations:

Gynaecologist or fertility specialist — for women trying to conceive without success after six to twelve months, or those requiring ovulation induction or IVF.

Endocrinologist — if testosterone levels are significantly elevated, symptoms are not responding to first-line treatment, or there are concerns about complex metabolic issues.

Cardiologist — if a lipid profile or blood pressure results indicate elevated cardiovascular risk.

Psychiatrist or psychologist — if anxiety, depression or other mental health concerns are significantly affecting quality of life.

Understanding your risks is the first step. Taking action is the next. For most women, a GP remains the right ongoing point of contact — monitoring symptoms, reviewing blood results and adjusting the management plan over time. Speak to a Healthway Medical GP and get a clearer picture of your health.

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Frequently Asked Question

Sources

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2. World Health Organization. Polycystic ovary syndrome. WHO Fact Sheet. Updated January 2026. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
3. Allen LA, Shrikrishnapalasuriyar N, Rees DA. Long-term health outcomes in young women with polycystic ovary syndrome: A narrative review. Clinical Endocrinology. 2022;97(2):187-198. https://pubmed.ncbi.nlm.nih.gov/34617616/
4. Yang Q, Benny P, Lee JJN, et al. Asian women with PCOS have enhanced ovarian reserve and ART outcomes, even at an advanced maternal age: a model for reproductive longevity? Human Reproduction Open. Published October 14, 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587411/
5. Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility. 2023;120(4):767-793. https://pubmed.ncbi.nlm.nih.gov/37589624/
6. Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update. 2014;20(5):748-758. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326303/
7. Tay CT, Teede HJ, et al. 2023 International Evidence-Based Polycystic Ovary Syndrome Guideline Update: Insights From a Systematic Review and Meta-Analysis on Elevated Clinical Cardiovascular Disease in Polycystic Ovary Syndrome. Journal of the American Heart Association. 2024. https://www.ahajournals.org/doi/10.1161/JAHA.123.033572
8. King TFJ. Polycystic ovary syndrome in Singapore. Annals of the Academy of Medicine Singapore. 2022;51(4):198-200. https://annals.edu.sg/polycystic-ovary-syndrome-in-singapore/