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Perspectives

Polycystic ovary syndrome and increased cardiometabolic risk

Anju E Joham, Helena J Teede

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Abstract

Although women with PCOS have more cardiovascular risk factors (abdominal obesity, impaired glucose tolerance, type 2 diabetes and dyslipidaemia), the long-term risk of cardiovascular disease in these women remains unclear.

Key Points

  • Polycystic ovary syndrome (PCOS) is a common heterogeneous condition underpinned by insulin resistance and associated with significant metabolic sequelae and an adverse cardiovascular risk profile.
  • Despite the increased prevalence of cardiovascular risk factors and early indicators of atherosclerosis in women with PCOS, the long-term risk of cardiovascular disease in these women remains unclear.
  • Appropriate screening and management of risk factors is crucial in women with PCOS.
  • Lifestyle change to prevent weight gain and reduce weight in those who are overweight should be first-line PCOS therapy.
  • Medical therapy is targeted to specific symptoms and does not supersede lifestyle therapy. The oral contraceptive pill regulates menstrual cycles and improves hyperandrogenism, and insulin sensitisers (primarily metformin) reduce insulin resistance.

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