PCOS Raises Cardiometabolic Risk Well Past Reproductive Age

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Polycystic ovary syndrome (PCOS) is commonly framed as a fertility problem, but Dr. Sara Gottfried argues it is a major cardiometabolic risk factor that becomes even more important to manage after age 50. PCOS is diagnosed when a woman has at least two of three features: cysts on the ovaries, signs of excess androgens (such as hirsutism — unwanted hair growth in a male pattern — or acne), and irregular periods (cycles of 35 days or more). For many women with PCOS, high insulin in the blood drives the ovaries to overproduce testosterone, worsening the hormonal imbalance. Gottfried recommends continuous glucose monitors (CGMs) as a highly effective behavior-change tool, while also noting that fasting and post-meal insulin levels can signal insulin resistance years before blood glucose rises, making insulin measurement an earlier warning sign.