The Cardiovascular Effects of PCOS and How to Protect Your Heart

If you or a loved one has been diagnosed with polycystic ovarian syndrome (PCOS), you’re likely familiar with its symptoms, such as infertility, weight gain, type 2 diabetes, and even depression.

But PCOS can increase your risk of one major condition that’s too often overlooked — cardiovascular disease (CVD).

In this article, we’ll look at the cardiovascular effects of PCOS Boston, and what you can do to protect your heart and blood vessels from the risks of CVD.

The Connection Between PCOS and Heart Health

It may seem strange that a hormonal disorder is connected to cardiovascular disease. So just how is PCOS related to heart health?

The answer may lie in insulin resistance, a highly prevalent feature among women with PCOS.1 Estimates suggest insulin resistance occurs in up to 95% of overweight women with PCOS and up to 75% in those with lean PCOS.2

The Role of Insulin Resistance in PCOS

In a healthy body, insulin moves glucose from the blood into cells, which stores the glucose so it can be used later for energy.

But with insulin resistance, your cells don’t react to insulin normally, resulting in high blood glucose levels. As a result, your pancreas begins to work overtime trying to produce more and more insulin. But over time, this effort takes its toll on your pancreas.

Studies have demonstrated a close relationship between insulin resistance and inflammation.3,4 And though the exact mechanism of inflammation in PCOS remains unknown, we know that chronic inflammation and PCOS are connected.5

Some experts suggest that elevated insulin levels boost androgen secretion from the ovaries and the adrenal glands.6 Others hypothesize that insulin resistance disrupts the hypothalamic-pituitary-ovarian (HPO) axis. The HPO axis is a tightly regulated communication network of hormones and neurotransmitters, which create the signals necessary for ovulation. When the HPO axis is thrown off balance, the result could be enhanced androgen production.7

Since many women with PCOS produce excess androgens, you can see why it’s important to get insulin levels and inflammation under control.

Women with PCOS are also prone to developing gestational diabetes, the core driving mechanism for which is insulin resistance.8 Gestational diabetes is a type of diabetes that develops during pregnancy and can affect both your health and your baby’s health.

If you’re planning to get pregnant, this further underlines the importance of being proactive to protect your heart health.

PCOS and Metabolic Syndrome

Insulin resistance is also closely tied to metabolic syndrome. Rather than an individual disease, metabolic syndrome is a term used to describe a cluster of conditions. The risk factors associated with metabolic syndrome include:9,10

• High fasting blood glucose (equal to or greater than 100 mg/dL)
• Low levels of high-density lipoprotein, also known as the “good” cholesterol (<40 mg/dL for men, <50 mg/dL for women)
• High levels of triglycerides, a type of fat, in the blood (>150 mg/dL)
• Large waist circumference (>35 inches in women, >40 inches in men)
• High blood pressure (130/80 mm Hg or higher)

Each of these is a risk factor for CVD. However, when a person has 3 or more of them, they are said to have metabolic syndrome. Metabolic syndrome is a serious condition that can increase your chance of type 2 diabetes, stroke, and other serious cardiovascular conditions.

If some of the risk factors listed above seem familiar, that’s because they’re also common characteristics of women with PCOS.

Many people believe CVDs are diseases of the elderly. And while it’s certainly true that CVD risk increases with age, women with PCOS exhibit these metabolic symptoms even at young ages.11

Why Don’t More People Talk About PCOS and Heart Health?

Women with PCOS are generally young, so much of the focus has revolved around managing current symptoms like infertility. This often leaves long-term risks like CVD largely ignored, which is frustrating and potentially dangerous.

To make things more complicated, some experts still debate whether the cardiovascular effects of PCOS Boston actually exists.

Some studies have shown that women with PCOS have a greater risk of developing CVD than those without PCOS.12,13,14

On the other hand, some experts argue that there is little, if any, connection. The authors of one 2018 article analyzed several studies and stated, “there is no credible evidence that there is greater CVD morbidity in all women with PCOS.”15

Even if they were to accept that there is increased CVD risk, the authors argued that it cannot be applied to all women with PCOS. Studies examine the most severe or classic types of PCOS (e.g., women displaying both high androgen levels and anovulation), but those with milder PCOS would have fewer risk factors.

Simply put, the increased CVD risk may not be uniform across all subtypes of PCOS. And since many women with PCOS tend to also have other CVD risk factors, the actual risk from PCOS may be small.

PCOS and Complications Around Childbirth

But a recently published article reported on another concerning aspect of the connection between PCOS and heart health — complications during delivery.

For the study, researchers analyzed more than 17 million U.S. births between 2002 and 2019. Of these, 195,675 women had PCOS. The data showed that PCOS was an independent predictor of cardiovascular complications during delivery, including:16

• Preeclampsia, a pregnancy complication characterized by high blood pressure
• Eclampsia, a severe form of preeclampsia that can include seizures and/or coma
• Peripartum cardiomyopathy, a condition in which the mother’s heart becomes weakened and enlarged
• Heart failure

Another analysis of multiple studies found that women with PCOS were two times more likely to have coronary artery calcification.17 This occurs when calcium collects in the walls of your coronary arteries, which supply blood to the heart. If left untreated, this calcification can lead to coronary artery disease, which in turn increases your risk of a heart attack.

So it’s clear that there are cardiovascular effects of PCOS Boston. And both doctors and women with PCOS should be paying close attention to protect their cardiovascular health.

How to Reduce Your Risk of Cardiovascular Disease

Given these risks, I believe it’s important for women of all ages who have PCOS to take measures to protect their heart health. Here are 4 ways to protect against the cardiovascular effects of PCOS Boston.

1. Address Hormone Imbalances

Finding hormonal balance is critical for women with PCOS.

But balancing your hormones goes beyond adding supplements or making sure your estrogen levels are within the normal range. Even natural supplements can throw off your hormones if they’re not the ones you need.

You also need to consider the numerous factors that influence your hormones, such as:

• Sleep quality
• Liver health
• Gut health
• Stress levels
• Nutrition
• Environment
• Genes

This means that it’s essential to look at the whole body when addressing hormone imbalances. And this is no easy feat. Many women become frustrated simply because they’re not following a plan customized to their needs.

I highly recommend working with a women’s health specialist who uses natural methods to correct the root cause(s) of your hormone imbalance(s). A women’s hormone specialist can help you sort out the multiple factors that may be at the root of your hormone imbalance and achieve hormonal harmony once again.

2. Commit to a Healthy Lifestyle

Lifestyle modifications, such as a healthy diet, regular exercise, and weight management are considered first-line therapies for women with PCOS.

Even shedding just 5% to 10% of your weight can have a positive effect on metabolic risk factors. Some studies show weight loss can even improve ovulation.18

Based on my experience as a women’s health specialist, I don’t believe that plant-based diets are the best for women — particularly women with PCOS. And it’s especially important for pregnant women to get plenty of protein and to eat for vascular health.

Some foods that promote vascular health include:

• Foods high in antioxidants, like berries
• Polyphenol-rich foods
• Foods rich in omega-3 fatty acids, such as salmon
• Whole grains
• Leafy greens

To learn about nutrient-packed foods that can fuel your health, check out my article here.

3. Balance Stress & Support Emotional Health

Women with PCOS have significantly higher levels of stress, anxiety, and depression than those without PCOS.19

The reason for this lies in cortisol. Known as our primary stress hormone, cortisol is responsible for many essential functions, including:20

• Regulating blood pressure
• Controlling blood sugar levels
• Helping control your body’s metabolism
• Influencing memory formation
• Controlling salt and water balance
• Helping the development of the fetus

Cortisol often gets a bad rap as the culprit for weight gain and other chronic health issues. If you have too much circulating cortisol over a prolonged period of time, it can put you in a state of chronic stress.

Excess cortisol has also been shown to increase:21

• Blood pressure
• Abdominal obesity
• Insulin levels
• Blood sugar levels
• Insulin resistance
• Imbalance of lipids, such as “bad” cholesterol to “good” cholesterol

Getting your stress under control isn’t easy. But the key is to start. Check out my blog on ten healthy stress hacks for more information on how to begin.

4. Tame Inflammation

According to research, women with PCOS have higher inflammation levels, which in turn aggravate obesity and high insulin levels. Many factors involved in inflammation and oxidative stress have also been shown to play a role in CVD risk.22

Along with the strategies discussed above, consider intermittent fasting. A study published in Cell showed that fasting reduces inflammation by reducing the number of monocytes, a type of pro-inflammatory cell.23

Vascular inflammation and oxidative stress are top contributors to CVD. Data indicate that women of reproductive age with PCOS have increased subclinical CVD. Subclinical CVD refers to abnormal changes in the blood vessels that occur without overt manifestation of the disease.24

So how do you test for vascular inflammation? One way is to test your cholesterol levels. Buildup of low-density lipoproteins (LDL), or “bad” cholesterol, in your arteries can trigger inflammatory responses. And experts agree that a direct link between cholesterol and inflammation exists, which means reducing “bad” cholesterol is a key strategy to improving cardiovascular health.

But not all cholesterol is bad. High-density lipoprotein (HDL), or “good” cholesterol, can actually lower your risk of CVD.

So is cholesterol still a reliable indicator of vascular health? I believe that a more reliable indicator of heart health is the ratio of two apolipoproteins — apoA1 and apoB.

ApoA1 is associated with HDL and can help lower your risk of CVD. On the other hand, ApoB is a type of protein found on LDL. Studies indicate that the apoB/apoA1 ratio is a more powerful indicator of one’s risk for future CVD.25 According to the Cleveland HeartLab, an apoB/apoA1 ratio below 0.63 indicates low risk of CVD, 0.63 to 0.78 a moderate risk, and above 0.78 a high risk for women.26

Doctor for Women With PCOS in Boston

PCOS is a complex, multifactorial condition that robs many women of their self-esteem and vitality.

If you’ve been diagnosed with PCOS and you’re concerned about your cardiovascular risk, I’m here and ready to help. I’ve worked with many women in your situation, and I’ve helped them optimize their health using natural healing methods. Let’s discuss the cardiovascular effects of PCOS Boston.

Not local to Boston? No problem. I offer tele-consults, which can be done in the comfort of your home. Schedule an initial consultation here.