Cysts do not present a health issue and will not need to be removed surgically; they do not lead to ovarian cancer.
Abnormal menstrual cycleAn abnormal menstrual cycle in some women with PCOS can make them more susceptible to certain health problems in later life but there are good treatments to help prevent these. Women with a very disrupted cycle – fewer than four periods a year – may have an increased risk of developing endometrial cancer. Fortunately, this is quite rare and the risk can be minimised or even eliminated by using appropriate treatments to regulate periods. The oral contraceptive pill (either combined pill or mini pill), progestogen tablets or a progestogen releasing coil are particularly effective.
Insulin resistanceOver time there is an increased risk of developing type 2 diabetes, diabetes in pregnancy, a high cholesterol level and, possibly, high blood pressure. About 10-20% of women with PCOS develop diabetes at some point. These problems may also raise your risk of having a stroke and heart disease in later life.
These increased health risks are due to the long-term insulin resistance (and also being overweight which is common in women with PCOS). Keeping weight down will help.