PMOS and Your Heart: What the Research Now Tells Us
PMOS — Polyendocrine Metabolic Ovarian Syndrome, recently renamed from PCOS — is one of the most common hormonal conditions affecting women of reproductive age, estimated to affect around 8–13% of women worldwide. Most conversations about PMOS focus on periods, skin, hair and fertility. What receives far less attention is what PMOS means for your heart.
That gap in conversation is worth closing. Here's what we know.
What Is PMOS?
PMOS was previously known as Polycystic Ovary Syndrome (PCOS). The renaming reflects a growing understanding that this condition is not primarily defined by ovarian cysts — it is a metabolic, whole-body condition involving hormonal imbalances, insulin resistance and chronic low-grade inflammation. The new name more accurately reflects the condition's systemic nature.
PMOS is characterised by higher levels of androgens, disrupted ovulation, and insulin resistance. These factors don't just affect reproductive health — they have real, documented effects on the cardiovascular system over time.
What Does the Research Say?
The evidence connecting PMOS to cardiovascular risk has been building for years, and a significant study published in 2026 in The Lancet brought it into sharp focus.
Researchers analysed health insurance data from more than 413,000 women aged 18–50 over a 22-year period and found that women with PMOS have around four times the risk of heart disease compared to women without the condition. Critically, this increased risk remained even after accounting for obesity, high blood pressure, high cholesterol and diabetes — suggesting that PMOS itself, independent of these other factors, contributes to cardiovascular risk.
The same study found that women with PMOS were roughly 2.5 times more likely to have a heart attack or stroke, and 3.4 times more likely to experience a transient ischaemic attack, compared to women without PMOS.
These are significant findings — and they underscore why cardiovascular health needs to be part of the PMOS conversation, not an afterthought.
Why Does PMOS Affect the Heart?
Several mechanisms are thought to be at play.
Insulin resistance is a hallmark of PMOS and is closely linked to cardiovascular risk. When cells don't respond effectively to insulin, blood glucose rises, and the body compensates by producing more insulin — a cycle that over time can damage blood vessels and contribute to atherosclerosis (the build-up of plaque in artery walls).
Chronic low-grade inflammation is also a feature of PMOS. Inflammation plays a direct role in cardiovascular disease, affecting the lining of blood vessels and contributing to plaque formation and arterial stiffness.
Hormonal imbalances, particularly elevated androgens, have been linked to adverse changes in cholesterol levels, blood pressure and body fat distribution — all of which influence cardiovascular risk.
Importantly, this cardiovascular risk profile can be present regardless of body weight. PMOS is not a condition that only affects women with elevated BMI — the metabolic and hormonal changes that drive cardiovascular risk occur across body sizes.
Does This Risk Carry Through to Menopause?
Yes — and this is an important point. The cardiovascular implications of PMOS are not limited to the reproductive years. As oestrogen declines at menopause, the cardiovascular protection it provides also reduces, and women with PMOS may be entering that transition with a higher baseline cardiovascular risk than women without the condition. This makes ongoing monitoring and proactive management even more important as women with PMOS move through perimenopause and beyond.
What Can You Do?
The research supports early cardiovascular screening and lifestyle-based prevention for women with PMOS. Practically, this means:
Regular monitoring of blood pressure, cholesterol and blood glucose — ideally as part of ongoing care with your GP, not just at diagnosis
Structured exercise, particularly a combination of resistance training and cardiovascular activity, which is one of the most effective lifestyle tools for improving insulin sensitivity, managing weight distribution, supporting healthier cholesterol levels and reducing cardiovascular risk
Open conversations with your GP about your cardiovascular risk profile, not just reproductive symptoms — PMOS is a whole-body condition and deserves a whole-body approach to care
How Exercise Physiology Can Help
Exercise is one of the most evidence-supported interventions for PMOS, with benefits that extend well beyond weight management. Structured, individualised exercise programming can help improve insulin sensitivity, support healthier body composition, reduce inflammation, and address cardiovascular risk factors — all of which are relevant to women with PMOS.
At CardioCare Clinic, we work with women across the full PMOS spectrum — from those newly diagnosed to those managing PMOS through perimenopause and beyond — to build exercise programs that are appropriate, progressive and genuinely effective.
If PMOS is part of your health picture and you haven't had a cardiovascular conversation yet, this is a good time to start.