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Managing PCOS/PMOS Long-Term: Preventing Type 2 Diabetes and Cardiovascular Risks
Polycystic ovary syndrome (PCOS) is often associated with irregular menstrual periods, acne, weight gain, and fertility problems. However, PCOS also affects reproductive health and increases your risk of type 2 diabetes and cardiovascular disease.
At Sarah Fishman Premier Endocrine in New York City, endocrinologist Sarah Fishman, MD, PhD, provides individualized care for hormonal and metabolic disorders. She helps patients manage PCOS symptoms and reduce long-term health risks.
How PCOS affects your metabolic health
Many people with PCOS experience insulin resistance, meaning the body’s cells don’t respond effectively to insulin. To compensate, the pancreas produces more insulin to help regulate blood sugar.
Over time, insulin resistance can contribute to elevated blood sugar levels, weight gain, and an increased risk of type 2 diabetes. Excess insulin may also stimulate androgen production, making some PCOS symptoms more difficult to manage.
Insulin resistance can occur regardless of body weight, making regular metabolic screening important even when you feel healthy.
Understanding your risk of type 2 diabetes
Women with PCOS have a higher risk of developing prediabetes and type 2 diabetes.
Because high blood sugar doesn’t always cause noticeable symptoms, regular screening helps identify problems early.
Dr. Fishman may recommend testing based on your medical history and individual risk factors. A 75-gram oral glucose tolerance test is the most accurate way to assess glucose status in women with PCOS. Other tests, including hemoglobin A1c and fasting blood glucose, may be appropriate in certain circumstances.
Depending on your results and risk factors, you may need repeat testing every one to three years.
Why PCOS can increase cardiovascular risks
PCOS is also associated with several factors that can affect your cardiovascular health.
These include:
- Insulin resistance
- High blood pressure
- Elevated LDL cholesterol
- Low HDL cholesterol
- High triglycerides
- Excess abdominal fat
- Sleep apnea
Not everyone with PCOS develops these problems, but having multiple risk factors can increase the likelihood of cardiovascular complications over time. Research has linked PCOS to an increased risk of cardiovascular disease, although the extent of that risk varies with age and other health factors.
Regular blood pressure checks, cholesterol testing, and metabolic assessments help identify changes that may require treatment.
Lifestyle changes that support long-term PCOS management
Healthy daily habits can support cardiovascular health and reduce your risk of long-term complications. Focus on:
- Regular physical activity
- Balanced, nutrient-rich meals
- Limiting processed foods and sugary beverages
- Maintaining a healthy weight, when appropriate
- Getting adequate sleep
- Managing sleep apnea, if present
Even small, consistent changes can improve your metabolic health and help you manage PCOS over time.
When medication may help
Metformin may help improve insulin sensitivity and certain metabolic outcomes in adults with PCOS. Dr. Fishman can determine whether this treatment is appropriate for you.
Other medications may be necessary to manage high blood pressure, abnormal cholesterol levels, or diabetes if these conditions develop.
Protect your health with ongoing PCOS care
Regular follow-up appointments allow Dr. Fishman to monitor your health and adjust treatment when necessary.
If you have PCOS or symptoms that may indicate a hormonal imbalance, call Sarah Fishman Premier Endocrine or book an appointment online to discuss your health and treatment options.
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