Hidden Heart Risk: The Link Between PCOS and Cardiovascular Disease

When most women hear the term PCOS, they think about missed periods, hormone imbalances, or fertility challenges. Heart disease usually isn’t part of the conversation. But growing research suggests it should be.

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women today, impacting an estimated 1 in 10 women of reproductive age. It’s typically diagnosed based on a combination of symptoms such as irregular menstrual cycles, higher-than-normal androgen (male-type hormone) levels, and changes in the ovaries seen on ultrasound.

While it’s often treated as a reproductive health issue, PCOS can affect the entire body—including the heart. Understanding this connection is an important step toward long-term health and prevention.

PCOS Is More Than a Reproductive Condition

PCOS is a complex hormonal disorder that can look different from woman to woman. Some experience irregular or absent periods, others struggle with acne or excess hair growth, and some face difficulty becoming pregnant. But behind the visible symptoms, PCOS often comes with metabolic changes that aren’t always talked about.

Many women with PCOS experience insulin resistance, weight gain, elevated cholesterol levels, or high blood pressure. These conditions don’t just affect hormones—they’re also well-known risk factors for cardiovascular disease.

Also read: What Is Polycystic Ovary Syndrome (PCOS)?

What the Research Is Telling Us

Over the past several decades, researchers have taken a closer look at how PCOS impacts heart health. What they’re finding is concerning but important: women with PCOS appear to have a higher risk of developing cardiovascular disease compared to women without it.

Studies have linked PCOS to increased rates of:

• High blood pressure
  
• Unhealthy cholesterol levels
  
• Type 2 diabetes
  
• Coronary heart disease
  
• Stroke
  

What’s especially notable is that this elevated risk can exist even in women with PCOS who are young or not overweight. That suggests PCOS itself—not just lifestyle or body weight—may play a role in long-term heart health.

Why Does PCOS Affect the Heart?

There isn’t one single reason, but rather a combination of factors that often overlap.

Insulin resistance is one of the biggest contributors. When the body doesn’t respond well to insulin, blood sugar levels rise, increasing the risk of diabetes and damaging blood vessels over time. This can make it easier for plaque to build up in arteries, raising the risk of heart disease.

Cholesterol imbalances are also common in PCOS. Many women have higher levels of “bad” LDL cholesterol and triglycerides, along with lower levels of “good” HDL cholesterol—another recipe for cardiovascular strain.

On top of that, researchers have found signs of chronic low-grade inflammation in women with PCOS. Inflammation can quietly damage blood vessels and interfere with how well they function, setting the stage for heart disease years down the road.

Also read: Diabetes Medications for Women: Understanding Today’s Treatments and What’s Right for You

Why This Risk Often Goes Unnoticed

One reason the PCOS–heart health connection is overlooked is timing. Cardiovascular disease typically develops later in life, while PCOS is often diagnosed in the teens or twenties. Because the effects aren’t immediate, the long-term risks can be easy to dismiss or forget.

Another challenge is that symptoms tend to dominate medical conversations. Appointments often focus on regulating cycles, managing acne, or addressing fertility concerns—while metabolic and cardiovascular screening may take a back seat.

But heart health doesn’t start in midlife. It’s built—or compromised—over decades.

The Good News: There’s a Lot You Can Do

Having PCOS does not mean you’re destined to develop heart disease. What it does mean is that awareness matters.

Regular screening for blood pressure, cholesterol levels, and blood sugar can catch problems early—often before symptoms appear. These simple checks can make a meaningful difference in long-term outcomes.

Lifestyle habits also play a powerful role. Balanced nutrition, regular physical activity, stress management, and maintaining a healthy weight can improve both symptoms and heart health. Even small, consistent changes can lead to improvements in insulin sensitivity and cholesterol levels.

In some cases, healthcare providers may recommend medications, such as those that improve insulin resistance, to support metabolic health. These decisions are always personal and should be made in partnership with a trusted provider.

PCOS doesn’t end with menopause, and neither do its potential health effects. Research suggests that women diagnosed with it earlier in life may continue to carry an elevated risk for cardiovascular disease as they age.

That’s why PCOS care shouldn’t stop at symptom management. It’s about taking a whole-body, lifelong approach to health—one that includes the heart.

A Bigger Picture of Women’s Health

At For Every Woman, we believe women deserve care that looks at the full picture—not just one diagnosis or one season of life. PCOS is a reminder that reproductive health, metabolic health, and heart health are deeply connected.

Understanding how PCOS affects the heart empowers women to ask better questions, seek preventive care, and advocate for their long-term well-being. When women are informed, they’re better equipped to care for themselves—today and for years to come.

Read next: Estrogen, Cholesterol, and Heart Disease: What You Should Know