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What You Should Know About the Link Between PCOS & Heart Health

The founder of #heart4PCOS, an initiative dedicated to raising awareness of PCOS-related cardiac health risks, shares what you need to know and how to keep your heart healthy.

February 12th, 2025 | 5 min. read

By Ashley Levinson, CMA, CST, CSFA

The name polycystic ovary syndrome (PCOS) implies that this condition is all about the ovaries, but it actually affects many different organs in the body, including the heart. Here's why PCOS patients have an increased risk of cardiovascular disease and how to take action.

In this article:

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormonal (endocrine) condition in women. It is a metabolic syndrome that affects several body systems and can cause significant long-term health consequences if left untreated - including heart disease. 

As someone who has been a longtime advocate and also has PCOS myself, I understand how challenging it can be to keep track of all the different challenges associated with the condition. That said, it's critical to educate yourself about these issues in order to live a healthy, long life.

Why does PCOS increase the risk of heart disease?

Here are some key features of PCOS that pose a threat to the cardiovascular system: 

  • Production of excess androgens ('male' sex hormones)
  • Anovulation* (the failure to ovulate properly)
  • Emerging research is also identifying the important roles of insulin receptors and chronic inflammation's role in PCOS, which can further the risks for cardiovascular disease. 

*Did you know that PCOS is the leading cause of anovulatory infertility?

PCOS Heart Facts You Should Know

Here's a brief summary that offers more specific information about the relationship between PCOS and cardiovascular health:

  • Women with PCOS have a higher risk of cardiovascular disease and a 4x higher risk of stroke. 
  • Research has linked PCOS with multiple risk factors for coronary heart disease including high cholesterol, irregular menstrual cycles, obesity, and hypertension. 
  • Researchers have also found that PCOS, with its symptomatic disorders of hypertension, excessive fat tissue in and around the abdominal area, blood fat disorders (high triglycerides and low HDL), high blood pressure, hyperandrogenism (elevated levels of male hormones), and insulin resistance are all contributing factors to cardiovascular disease. 
  • Insulin, in particular, tends to be a consistent risk factor with PCOS, as approximately 70% of patients develop insulin resistance. 
  • As insulin comes in contact with the interior wall of the arteries, it damages the tissue, causing the initial injury that produces plaque. Having insulin resistance and PCOS can directly cause changes in blood lipids and overall cardiovascular health that contribute to the formation of heart disease. 
  • PCOS patients are at higher risk to develop high blood pressure, lipid disorders, diabetes, and coronary artery disease.
  • As many as 40% of PCOS patients as young as age 30-45 may have coronary calcification (a warning of heart attack risk).
  • Researchers have discovered that the carotid artery, which is located in the neck, is thicker in women with PCOS equaling a higher heart disease risk.
  • With PCOS, 50% of patients become diabetic by age 40, a risk factor for heart disease.
  • Patients with PCOS can develop coronary artery disease as early as in their twenties. 

High insulin levels associated with PCOS can lead to heart and blood vessel problems.

 ...which, you guessed it, contributes to the risk of heart issues. Specifically, higher insulin can present the following issues in your cardiovascular system:

  • Hardening of the arteries (atherosclerosis)
  • Coronary artery disease and heart attack
  • High blood pressure
  • High cholesterol
  • Stroke

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Be Proactive

It is important, at minimum, to have a yearly appointment with a PCOS-friendly doctor to have bloodwork checked. Even if you are under 40, PCOS can present heart disease risks.

Even young women in their 20s with PCOS can start developing the plaque deposits leading to cardiovascular disease. Regular checkups and sound treatment plans are therefore vital to long-term health with this syndrome. 

PCOS is not a life sentence, even though it is a syndrome you will have to continue to manage throughout your lifetime. The good news? Knowledge is power, and together, we have the choice (and chance!) to change our lives through education, advocacy, and support.

My hope is that every voice speaks up and out about their experience with PCOS. I hope it leads to more change and hopefully, a new era of better understanding and treatment for all those living with PCOS. 

Feeling overwhelmed?

I get it! Please know that you are not alone.

Yes, you are your own best advocate, but the rest of the PCOS community is here to speak up for you too. There are millions of people living with this condition and many doctors who are well-versed in PCOS symptoms and treatment. All of them are standing in your corner.

Let's keep PCOS patients' hearts beating by spreading awareness and working to lower heart disease risks for individuals with polycystic ovary syndrome.

Ashley Levinson, CMA, CST, CSFA

Ashley Levinson (AKA @PCOSgurl) has worked diligently within the PCOS community for over 20 years, advocating for increased funding, research and awareness for Polycystic Ovary Syndrome.

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