PMOS and Heart Disease: Why Women Need Early Cardiovascular Screening
A major new study has brought renewed attention to an important aspect of women’s health: the potential link between polyendocrine metabolic ovarian syndrome (PMOS) and cardiovascular disease.
PMOS is the newer name for the condition historically known as polycystic ovary syndrome (PCOS). While PCOS has traditionally been associated with irregular periods, fertility difficulties, acne, excess hair growth and hormonal changes, modern research increasingly recognises that the condition can affect much more than reproductive health. Read our earlier article that details the reasons for the PCOS and the PMOS nomenclature change.
A new study published in The Lancet Obstetrics, Gynaecology & Women’s Health in July 2026 has reported a significantly higher incidence of atherosclerotic cardiovascular disease events among women diagnosed with PMOS. The large analysis examined health insurance data involving more than 2.4 million women in the United States over a 22-year period, including approximately 413,000 women aged 18–50 with PMOS. According to reporting on the study, women with PMOS were approximately four times more likely to experience cardiovascular events such as heart attack or stroke than women without the condition.
These findings are important because they reinforce a message that doctors and researchers have increasingly emphasised: PMOS should not be viewed solely as a fertility or menstrual condition.
It is a complex endocrine and metabolic condition that may be associated with insulin resistance, abnormal cholesterol, high blood pressure, diabetes, weight-related metabolic changes and other factors that can influence cardiovascular health.
At Ocean Medical Practice Bondi, our GPs believe that women with PMOS deserve a comprehensive approach to their health — including appropriate assessment of cardiovascular and metabolic risk.
If you live in Bondi, Bondi Beach, Bondi Junction, North Bondi, Tamarama, Bronte, Bellevue Hill or elsewhere in Sydney’s Eastern Suburbs, our doctors can help you understand your individual risk factors and develop a personalised prevention plan.
Book an appointment online with Ocean Medical Practice Bondi to discuss PMOS, cardiovascular risk, women’s health and your long-term wellbeing.
Does PMOS Increase the Risk of Heart Disease?
The short answer: emerging evidence suggests a significant association
The answer is increasingly yes — although it is important to understand exactly what the research means. The new 2026 study adds to a growing body of evidence suggesting that women with PMOS/PCOS have a higher risk of cardiovascular disease than women without the condition.
The study’s large US population analysis found a significantly higher incidence of atherosclerotic cardiovascular disease events among women with PMOS. The reported association remained important even after accounting for recognised cardiovascular risk factors such as obesity, high blood pressure and diabetes.
The reported findings are significant because previous research has often focused more heavily on cardiovascular risk factors rather than actual cardiovascular events. It is important to distinguish between:
Cardiovascular risk factors
These include:
- High blood pressure
- Abnormal cholesterol
- High triglycerides
- Insulin resistance
- Prediabetes
- Type 2 diabetes
- Smoking
- Physical inactivity
- Excess body fat
- Sleep apnoea
And:
Actual cardiovascular disease events
These include:
- Heart attack
- Ischaemic heart disease
- Stroke
- Other atherosclerotic cardiovascular events
The 2023 International Evidence-Based Guideline for the Assessment and Management of PCOS already recognised that women with PCOS should be considered at increased cardiovascular risk and recommended comprehensive cardiovascular risk-factor assessment. It recommends a lipid profile at diagnosis for all women with PCOS, regardless of age or BMI, and annual blood-pressure measurement, including when planning pregnancy or fertility treatment.
A 2024 systematic review and meta-analysis that informed the international guideline also found increased risks of several clinical cardiovascular outcomes among women with PCOS, including composite cardiovascular disease, ischaemic heart disease, myocardial infarction and stroke.
The new 2026 research therefore adds to an already developing evidence base. However, the exact cardiovascular risk for an individual woman cannot be determined simply by multiplying her risk by four.
Individual risk depends on many factors, including:
- Age
- Blood pressure
- Cholesterol
- Blood glucose
- Smoking
- Family history
- Weight and body composition
- Physical activity
- Diabetes
- Pregnancy history
- Other medical conditions
- Medications
This is why personalised cardiovascular assessment is so important.
At Ocean Medical Practice Bondi, our doctors can help women with PMOS understand their individual cardiovascular risk rather than relying solely on a population-level statistic.
Why Might PMOS Be Associated With Heart Disease?
There is unlikely to be one single explanation. PMOS is a complex condition involving hormonal, metabolic and potentially inflammatory pathways. Several factors may interact over many years to influence cardiovascular health.
Understanding these possible mechanisms helps explain why early screening and prevention are important.
1. Insulin Resistance
Insulin resistance is common in PMOS and can occur in women across the BMI spectrum. Insulin is a hormone that helps move glucose from the bloodstream into cells where it can be used for energy. When the body’s tissues become less responsive to insulin, the pancreas may compensate by producing more insulin.
Over time, insulin resistance can contribute to:
- Higher blood glucose
- Prediabetes
- Type 2 diabetes
- Increased abdominal fat
- Higher triglycerides
- Abnormal cholesterol patterns
- Higher blood pressure
These factors are all relevant to cardiovascular health. Importantly, a woman can have insulin resistance without knowing it. She may feel completely well while metabolic changes gradually develop.
This is one reason why regular GP assessment can be valuable for women with PMOS.
At Ocean Medical Practice Bondi, our GPs can discuss appropriate metabolic screening based on your individual health history and risk factors.
2. Abnormal Cholesterol and Triglycerides
Some women with PMOS may have an adverse lipid profile.
This can include:
- Higher LDL cholesterol
- Higher triglycerides
- Lower HDL cholesterol
- Other changes in lipid metabolism
Over time, unhealthy cholesterol levels can contribute to atherosclerosis, the gradual accumulation of fatty plaques within artery walls.
Atherosclerosis can contribute to cardiovascular events such as heart attack and stroke.
The international PCOS guideline recommends that women with PCOS have a lipid profile at diagnosis regardless of age and BMI. Further testing should be based on the results and the individual’s broader cardiovascular risk profile.
A cholesterol test is a relatively straightforward way to identify an important modifiable cardiovascular risk factor.
Our Bondi doctors and GPs at Ocean Medical Practice can organise appropriate cardiovascular and metabolic screening as part of your ongoing healthcare.
3. High Blood Pressure
High blood pressure is one of the most important modifiable risk factors for:
- Heart attack
- Stroke
- Kidney disease
- Cardiovascular disease
It is often called a “silent” condition because many people have no obvious symptoms.
Women with PMOS may have an increased prevalence of hypertension, particularly when other metabolic risk factors are present.
The international PCOS guideline recommends blood pressure measurement at least annually for women with PCOS and when planning pregnancy or seeking fertility treatment.
Routine blood pressure checks can therefore form an important part of long-term PMOS care.
At Ocean Medical Practice Bondi, your GP can monitor your blood pressure and discuss appropriate lifestyle measures or treatment if your readings are elevated.
4. Prediabetes and Type 2 Diabetes
PMOS is strongly associated with abnormalities in glucose metabolism.
Insulin resistance can increase the risk of:
- Prediabetes
- Type 2 diabetes
- Gestational diabetes during pregnancy
Diabetes is itself a major cardiovascular risk factor.
For women with PMOS, checking glucose metabolism is therefore not simply about preventing diabetes.
It is also part of protecting long-term cardiovascular health.
Depending on your individual circumstances, your GP may recommend:
- Fasting blood glucose
- HbA1c
- An oral glucose tolerance test
The international guideline places particular importance on assessing glycaemic status in women with PCOS because of their increased risk of impaired glucose tolerance and type 2 diabetes.
Your GP can advise which test is most appropriate for you.
5. Weight Gain and Central Adiposity
Weight is a complex issue in PMOS.
Some women with PMOS have overweight or obesity, while others have a BMI within the healthy range.
It is therefore important not to assume that cardiovascular risk is determined by body weight alone.
When excess body fat is present — particularly around the abdomen — it may be associated with:
- Increased insulin resistance
- Higher blood pressure
- Abnormal cholesterol
- Increased metabolic inflammation
- Higher risk of type 2 diabetes
For women who would benefit from weight reduction, even modest and sustainable improvements may have positive effects on metabolic health.
However, the goal should not be rapid or extreme weight loss.
A healthy approach should focus on:
- Nutrition
- Physical activity
- Sleep
- Metabolic health
- Mental wellbeing
- Sustainable behaviour change
At Ocean Medical Practice Bondi, our doctors can discuss personalised weight management options where appropriate.
6. Chronic Low-Grade Inflammation
Researchers have explored whether chronic low-grade inflammation may contribute to the relationship between PMOS and cardiovascular disease.
Inflammation is involved in the development and progression of atherosclerosis.
However, the relationship is complex.
It is not yet clear how much of the cardiovascular risk associated with PMOS is directly attributable to inflammation and how much is mediated through:
- Insulin resistance
- Adiposity
- Diabetes
- Hypertension
- Abnormal cholesterol
- Other metabolic factors
This remains an active area of research.
The important message for patients is that PMOS is a complex, multi-system condition and cardiovascular health should be considered as part of comprehensive long-term care.
7. Hormonal and Androgen-Related Factors
PMOS can involve elevated androgen levels or increased androgen activity.
Androgens may interact with:
- Insulin resistance
- Body composition
- Metabolic health
- Blood vessel function
Some research has suggested that androgen excess may contribute independently to cardiovascular risk, although the precise mechanisms remain under investigation.
This is another reason why PMOS should be viewed as a complex endocrine condition rather than solely a disorder of reproductive health.
8. Obstructive Sleep Apnoea
Obstructive sleep apnoea is more common among women with PMOS, particularly when overweight or obesity is present.
Sleep apnoea can contribute to:
- High blood pressure
- Insulin resistance
- Poor sleep quality
- Daytime fatigue
- Metabolic dysfunction
Untreated sleep apnoea may also contribute to cardiovascular risk.
If you:
- Snore heavily
- Wake feeling unrefreshed
- Have witnessed pauses in breathing during sleep
- Experience morning headaches
- Feel excessively sleepy during the day
speak with your GP. Assessment and treatment of sleep apnoea may be an important part of comprehensive PMOS care.
9. Pregnancy-Related Cardiovascular Risk
PMOS can be associated with increased risks during pregnancy, including:
- Gestational diabetes
- High blood pressure during pregnancy
- Hypertensive disorders of pregnancy
- Pre-eclampsia
These pregnancy complications are relevant beyond pregnancy itself.
Conditions such as pre-eclampsia and gestational diabetes may be associated with increased cardiovascular risk later in life.
Women with PMOS who are planning pregnancy should consider discussing their health with their GP before conception where possible.
A preconception consultation can provide an opportunity to review:
- Blood pressure
- Blood glucose
- Weight
- Medications
- Lifestyle
- Cardiovascular risk
- Pregnancy-related risk factors
At Ocean Medical Practice Bondi, our GPs can provide preconception and women’s health care and coordinate referrals when specialist input is required.
What Heart Health Screening Should Women With PMOS Consider?
There is no single “PMOS heart test” that can predict whether an individual woman will develop heart disease.
Instead, cardiovascular prevention involves building a complete picture of your health.
Your GP may consider:
Blood Pressure
Regular blood pressure measurement is recommended as part of PMOS/PCOS cardiovascular risk management.
Cholesterol
A lipid profile can assess:
- Total cholesterol
- LDL cholesterol
- HDL cholesterol
- Triglycerides
Blood Glucose
Your GP may recommend testing for:
- Prediabetes
- Diabetes
- Impaired glucose tolerance
Testing may involve HbA1c, fasting glucose or an oral glucose tolerance test depending on your circumstances.
Weight and Waist Circumference
Weight trends and central adiposity can provide useful information about metabolic health.
However, BMI alone does not define cardiovascular risk.
Smoking
Smoking is one of the most important modifiable cardiovascular risk factors.
If you smoke or use nicotine products, your GP can discuss evidence-based strategies to help you stop.
Family History
Tell your GP if close relatives have experienced:
- Heart attack
- Stroke
- High cholesterol
- Diabetes
- High blood pressure
- Cardiovascular disease at a young age
Family history can be an important part of assessing your overall risk.
Physical Activity
Your GP can discuss how active you are and help identify realistic ways to increase your daily movement.
Diet and Nutrition
A dietary assessment can identify opportunities to improve:
- Cardiovascular health
- Blood glucose
- Cholesterol
- Weight management
- Overall metabolic health
Sleep
Symptoms of obstructive sleep apnoea should be considered, particularly when risk factors are present.
Mental Health
Depression, anxiety and psychological distress can coexist with PMOS and may affect sleep, physical activity, eating patterns and overall wellbeing.
Comprehensive care should address the whole person.
Should Women With PMOS Have a Heart Health Check?
This is an increasingly important question following the publication of the new 2026 cardiovascular study.
The answer is that women with PMOS should have their cardiovascular risk factors assessed, even if they are young and otherwise feel healthy.
The 2023 international PCOS guideline recommends cardiovascular risk-factor assessment for women with PCOS and recommends a lipid profile at diagnosis regardless of age or BMI, with annual blood pressure measurement.
The guideline also notes that PCOS should be considered in the context of cardiovascular risk, while recognising that absolute cardiovascular risk in younger premenopausal women is generally low.
The important distinction is between:
Cardiovascular risk-factor screening
and
Formal absolute cardiovascular risk calculation.
These are not the same thing.
A younger woman with PMOS may have:
- High blood pressure
- Abnormal cholesterol
- Prediabetes
- Diabetes
- A strong family history
- Smoking exposure
- Significant obesity
- Sleep apnoea
Even if she is too young for routine population-based absolute cardiovascular risk calculation, these factors still deserve attention.
The new study’s findings strengthen the case for taking cardiovascular health seriously in women with PMOS.Book a PMOS and Heart Health Consultation at Ocean Medical Practice Bondi
The latest research reinforces an important message:
PMOS is about more than periods and fertility.
Your hormonal condition may also be relevant to your metabolic and cardiovascular health.
If you have PMOS or a previous PCOS diagnosis, consider speaking with your GP about:
- Blood pressure
- Cholesterol
- Blood glucose
- Diabetes risk
- Weight management
- Physical activity
- Nutrition
- Smoking
- Sleep
- Family history
- Overall cardiovascular risk
At Ocean Medical Practice Bondi, our GPs provide personalised women’s health and preventive healthcare for patients across Bondi, Bondi Beach, Bondi Junction, North Bondi, Tamarama, Bronte, Bellevue Hill and Sydney’s Eastern Suburbs.
You do not have to wait until you develop symptoms to take your heart health seriously.
Book an Appointment Online
Book an appointment with Ocean Medical Practice Bondi today to discuss PMOS, PCOS, cardiovascular risk, metabolic health, weight management or your broader women’s health needs.
Our experienced GP team can help you understand your individual risk factors and develop a personalised plan focused on prevention, early detection and long-term health.
Book online today at Ocean Medical Practice Bondi:
https://oceanmedical.com.au/book/
In the next article, our Bondi doctors team explore how you can manage the Risk Factors.
Last medically reviewed: 28 July 2026
Reviewed by: Doctors at Ocean Medical Practice – Bondi Medical Centre
Location: Bondi Road, Bondi NSW
