PCOS, the most common endocrine disease in women of reproductive age, puts women at an increased cardiometabolic risk, a cluster of metabolic and cardiovascular abnormalities including hypertension, abdominal obesity, insulin resistance, dyslipidaemia, and atherosclerosis, which predispose individuals to cardiovascular disease (CVD) and Type 2 diabetes. A statement from the Experts Group on Inositol in Basic and Clinical Research and PCOS (EGOI-PCOS) and the Italian Association of Hospital Cardiologists (ANMCO) encourages clinicians to view PCOS not only through the lens of reproductive health, but as a multifaceted endocrine–metabolic disorder.
The prevalence of PCOS has gradually increased in recent years, and several studies have already highlighted the increased risk of CVD compared with healthy populations. Studies have shown that a large percentage of women with PCOS exhibit cardiovascular risk factors such as dyslipidaemia, insulin resistance, hypertension, gestational and early-onset diabetes, and metabolic syndrome. A cross-sectional study using a large USA-based digital cohort suggested that PCOS was significantly associated with a higher prevalence of metabolic and cardiovascular conditions, including prediabetes, Type 1 diabetes, and Type 2 diabetes.
Importantly, PCOS is not a uniform disorder. Distinct phenotypes exist, and the risk of cardiometabolic disease differs between them. Women with hyperandrogenic PCOS appear particularly vulnerable, possibly due to genetic factors, dyslipidaemia, hypertension, and excessive androgen.
The findings emphasise the need for early identification and careful monitoring of metabolic risk factors in women with PCOS. Appropriate risk assessment before prescribing treatment, along with personalised management strategies, could help reduce the long-term burden of cardiometabolic disease in this population. Early intervention to address metabolic complications may be crucial in preventing progression to diabetes and CVD later in life.
Reference
Geraci G et al. Women with PCOS have a heightened risk of cardiometabolic and cardiovascular diseases: statement from the Experts Group on Inositol in Basic and Clinical Research and PCOS (EGOI-PCOS) and Italian Association of Hospital Cardiologists (ANMCO). Front Cardiovasc Med. 2025;12:1520490.
