Most people think of polycystic ovary syndrome (PCOS) as a reproductive condition, but it has wider-reaching effects than you may realize.
In Queens and White Plains, New York, board-certified OB/GYN Daniel S. Kushner, MD, and our team help women understand how PCOS affects the entire body, including your cardiovascular system. During February, the month for matters of the heart, we believe it's the right time to delve into the surprising link between PCOS and your cardiovascular health.
PCOS starts with an imbalance in hormones called androgens. While usually considered male hormones, women have androgens, too, but in much smaller amounts than their male counterparts.
In women with PCOS, androgen levels are unusually high. This imbalance influences how the body processes sugar, stores fat, and regulates inflammation.
Over time, these changes cause added stress on blood vessels and the cardiovascular system, increasing the risk of heart-related problems.
It starts with oxidative stress and inflammation. Oxidative stress happens when the body has too many unstable molecules (free radicals), and not enough antioxidants (the protective substances that neutralize them). Some people visualize this process as rust forming inside the body.
Over time, oxidative stress damages blood vessels and triggers chronic inflammation. This damage makes it more difficult for blood vessels to work normally, forcing the heart and entire circulatory system to work harder than they should.
Because of these underlying processes, women with PCOS are more likely to develop several cardiovascular risk factors.
Chronic high blood pressure narrows and damages the arteries that supply blood to the heart, forcing it to work too hard.
Women with PCOS often have high levels of "bad" cholesterol (LDL), and low levels of "good" cholesterol (HDL).
Weight gain is a common battle for many women with PCOS. It's particularly common for fat to build up around the belly. Abdominal fat is especially harmful because it increases inflammation and insulin resistance, both of which place added strain on the heart.
Insulin resistance, which often goes hand-in-hand with the other factors we've mentioned, is extremely common. Research shows that up to 80% of women with PCOS have insulin resistance.
This means the body doesn't use insulin properly, causing blood sugar levels to remain elevated. Over time, high blood sugar damages blood vessels and significantly increases the risk of heart disease.
Beyond these risk factors, newer research shows that PCOS itself is linked to more serious heart outcomes. Studies confirm that women with PCOS have a higher risk of cardiovascular events at younger ages, including heart attacks and strokes.
Some research has found a more than 50% higher risk of developing severe cardiovascular conditions compared to women without PCOS.
Cardiovascular risk may also increase later in life. One study showed that women with PCOS continued to experience elevated cardiovascular risk after menopause, suggesting that long-term monitoring is important even as hormone levels change.
If you have PCOS, Dr. Kushner may recommend regular heart health screenings. Important evaluations that can help predict future cardiovascular and metabolic risk include A1C testing, fasting glucose, cholesterol and triglyceride levels, blood pressure, and waist circumference measurements.
Undergoing regular monitoring and taking action promptly when heart risk factors appear can help you maintain a healthy heart with PCOS. If you have questions about PCOS and your health, schedule an appointment with Daniel S. Kushner, MD, today.
