One of the most prevalent endocrine disorders, the Polycystic Ovary syndrome (PCOS), affects up to 10 per cent of women. It causes enlarged ovaries with cysts, irregularities in your periods and produces too many androgens or men’s hormones. Many women complain about acne, hair fall, menstrual disorders, weight gain and fertility issues. But they need to worry about its impact on heart health, particularly when they develop high blood pressure and Type 2 diabetes. That’s why they need to watch their diet and exercise even more.
Even though mortality from coronary disease does not appear to be higher, evidence shows that women with PCOS have a higher risk of coronary artery disease and myocardial infarction than women who don’t.
High testosterone levels and insulin resistance in women with PCOS have been linked to endothelial and diastolic dysfunction. In endothelial dysfunction, the heart vessels narrow down instead of dilating, causing chest pain. This increases the risk of even small plaques rupturing inside a blood vessel. This can block blood flow to your heart muscle, triggering a heart attack. Diastolic dysfunction occurs when your lower heart chambers don’t relax as they should.
Also, abdominal obesity, a high body mass index (BMI) and insulin resistance raise your levels of homocysteine, an amino acid. When it’s high it means you are deficient in folate, Vitamins B6 and B 12, which can impact the heart. In fact, it increases the chances of left ventricular hypertrophy (LVH), which is thickening of the walls of the lower left heart chamber that affects the pumping of blood. The abdominal or belly fat can push up triglycerides and cholesterol.
What lifestyle factors can further amplify cardiovascular risk in women with PCOS?
The biggest lifestyle triggers are physical inactivity and sedentary habits, which can lead to rapid weight gain. Besides, a carbohydrate-heavy diet, alcohol, work or personal stress, irregular sleep patterns and disrupted circadian rhythms further compound this risk. That’s why only a holistic lifestyle management can work for women with this condition.
What are some of the subtle symptoms of heart disease that women with PCOS should be aware of?
Chest discomfort, especially in women, is not often severe or even the most obvious sign. Heart attack pain is frequently described by women as feeling tight or pressured. Additionally, chest pain is not always a sign of a heart attack.
Symptoms of a heart attack other than chest pain include:
- Discomfort in upper back, upper belly (abdomen), neck, jaw and shoulder
- Respiration difficulty
- One or both arms hurting
- Vomitting or nausea
- Sweating
- Feeling faint or unsteady
- Unusual tiredness
- Indigestion and heartburn
How does exercise play a pivotal role in managing cardiovascular risks for PCOS patients?
Guidelines for PCOS suggest at least 150 minutes of physical activity per week. Women with PCOS may benefit from moderate aerobic exercise programmes that last less than three months and occur three times per week for at least 30 minutes. Even without significant weight loss, exercise therapies in PCOS have led to improvements in lipid profile, ovulation and insulin sensitivity of up to 30 per cent during a 12-week period. Lean women with PCOS can still benefit from exercise to enhance their cardiometabolic profile because the increased CVD risk factors linked to PCOS are not primarily attributable to fat. Affected women are advised cardio, strength training and core exercises.
How can regular check-ups and heart health assessments make a difference?
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Regular check-ups and heart health assessments play a crucial role in the comprehensive care of individuals with PCOS. By conducting routine cholesterol and blood sugar tests, healthcare providers can detect underlying issues like diabetes or prediabetes, even when fasting blood sugar levels appear normal.
The gold standard for identifying diabetes or prediabetes is the oral glucose tolerance test, ensuring accurate diagnosis. Additionally, assessing the risk of sleep apnea through questionnaires or overnight sleep studies is essential, as it is a common comorbidity in PCOS. Monitoring testosterone and DHEAS levels is vital for women with moderate to severe hirsutism, aiding in the management of excess hair growth.
Regular health check-ups also enable healthcare professionals to address the potential metabolic and reproductive complications that can arise in women with PCOS. Moreover, considering the increased risk of depression and anxiety in these individuals, routine assessments can help in providing necessary mental health support.
First published on: 08-09-2023 at 12:20 IST
