By Dr. Aabha Bhalerao

September 18, 2023 (IANSlife) Polycystic Ovary Syndrome (PCOS), a common endocrine disorder among women, has garnered increasing attention in recent years due to its intriguing connection to cardiovascular health. While mortality rates from circulatory diseases in PCOS patients remain comparable to those of women with regular menstrual cycles, mounting evidence suggests a heightened risk of coronary artery disease and myocardial infarction in PCOS-afflicted women.

This connection appears to be rooted in factors such as endothelial and diastolic dysfunction, high testosterone levels, and insulin resistance, all of which are prevalent in PCOS cases. In addition, obesity, elevated homocysteine levels, and left ventricular hypertrophy (LVH) have been independently associated with increased cardiovascular risk in PCOS patients, alongside traditional risk factors like total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels.

The intriguing connection between PCOS and cardiovascular health

Notably, obesity and type 2 diabetes frequently coexist with PCOS, posing a direct threat to heart health. These comorbid conditions elevate the lifelong risk of heart disease for PCOS-affected women. Genetic predisposition aside, other lifestyle factors contribute to the heightened cardiovascular risk in PCOS, including sedentary habits, poor dietary choices, stress, irregular sleep patterns, and disruptions in circadian rhythm.

Lifestyle factors amplifying cardiovascular risk in women with PCOS

In women with PCOS, recognizing the symptoms of heart disease can be challenging, as chest discomfort is not always severe or the most prominent sign. Women often describe the pain of a heart attack as tight or pressing, and chest pain may not always be present. Subtle symptoms, more common in women, include upper back, upper abdominal, neck, jaw, and shoulder discomfort, as well as breathlessness, arm pain, nausea, sweating, lightheadedness, unusual fatigue, and indigestion. These symptoms underscore the importance of heightened vigilance among PCOS-affected women regarding their heart health.

The role of exercise in managing cardiovascular risk for PCOS patients

Exercise emerges as a pivotal player in managing cardiovascular risk for PCOS patients. Moderate aerobic exercise programs, lasting less than three months and conducted at least three times a week for 30 minutes, have demonstrated significant benefits for PCOS-affected women. Lifestyle modifications, including exercise, have led to improvements in lipid profiles, ovulation, and insulin sensitivity, with gains of up to 30% within a 12-week period. Even when cardiovascular risk factors in PCOS are not solely tied to obesity, exercise can still enhance the cardiometabolic profile, underlining its importance in PCOS management.

Regular check-ups and heart health assessments

Regular check-ups and heart health assessments can make a substantial difference in the lives of women with PCOS. Upon PCOS diagnosis, cholesterol and blood sugar tests are typically administered, with oral glucose tolerance tests offering the most accurate identification of diabetes or prediabetes. Furthermore, assessing sleep apnea through questionnaires or overnight sleep studies can be crucial. Blood tests measuring testosterone and dehydroepiandrosterone sulfate (DHEAS) may be advisable for women exhibiting moderate to severe hirsutism (excess hair growth). Consistent health checks are essential to monitor potential metabolic and reproductive issues common to all women with PCOS, as well as address the frequently accompanying depression and anxiety.

In conclusion, the link between PCOS and cardiovascular health is a multifaceted and intriguing puzzle that warrants attention. Lifestyle factors, subtle symptoms of heart disease, exercise, and regular health assessments all play vital roles in managing cardiovascular risk for PCOS patients. By understanding and addressing these facets, we can strive to protect the heart health of women living with PCOS and empower them to lead healthier, happier lives.

(Dr. Aabha Bhalerao is a Consultant Gynaecologist at Ruby Hall Clinic Hinjewadi)

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