Polycystic Ovary Syndrome and Heart Disease

By Joseph Hazan,M.D., FACOG

Polycystic Ovary Syndrome patients

frequently have increased heart disease risk.

This is related to abnormal lipid profile,

hypertension, insulin resistance and obesity.

Patients with PCOS have increased facial

hair, loss of scalp hair, elevated andogen

levels, lack of ovulation and infertility.

The normal ovulation does not occur in

PCOS patients and LH levels are elevated while

FSH levels are normal or slightly low.

Because of elevated estrogen (estradiol) levels

FSH is low (due to negative feedback).

This causes theca cells in the ovaries to proliferate

and that leads to increased androgen secretion.

Lack of periods and ovulation follows.

Metabolic syndrome and cardiometabolic

syndrome findings are also present in PCOS.

Obesity, high blood pressure and insulin

resistance are seen in these syndromes.

It is known that insulin resistance ,

hyperinsulinemia (high blood levels of insulin)

are  also related to abnormal lipid profiles.

This is because in these patients with high

insulin and androgen levels the fat cells

release the FFA’s (free fatty acids) into the

circulation. Also these FFA’s cause the liver

to make more VLDL (very low-density

lipoprotein) which lead to high

triglyceride levels.

Additionally some of these patients have

elevated CRP (C-reactive protein) which is a marker

of heart disease including myocardial infarction,

sudden cardiac death, peripheral

vascular disease and stroke.

Some patient could have no apparent

cardiovascular problem and normal lipid levels, but

high CRP (over 5 mg/L).

If the hsCRP (high sensitivity C-reactive protein) is high,

these patient may benefit from treatment to lower

these levels and reduce their cardiovascular risk.

PCOS patient can benefit from screening for

cardiovascular risk and proper intervention.