PCOS increases cardiovascular risk in menopause
The alarm comes from an endocrinologist at SBEM-SP
Polycystic ovary syndrome (PCOS) is a chronic condition that accompanies women throughout their lives and its effects do not disappear with the end of the reproductive period. During the transition to menopause (climacteric), the situation can become even more complex, due to an increase in metabolic and cardiovascular risk factors.
According to Larissa Garcia Gomes, endocrinologist at the Brazilian Society of Endocrinology and Metabology – Sao Paulo Region (SBEM-SP), the reduction in estrogen during menopause adds to the changes already caused by PCOS. This increases problems such as hypertension, insulin resistance, type 2 diabetes, dyslipidemia, and fatty liver disease.
“Polycystic ovary syndrome is a lifelong disease. In the initial stages, symptoms of hyperandrogenism, such as acne, hirsutism and menstrual irregularities, attract the most attention. During menopause, attention focuses on the increase in metabolic and cardiovascular comorbidities,” explains the doctor.
Studies on polycystic ovary syndrome in menopause
Studies indicate that women with PCOS are up to four times more likely to develop diabetes. In addition to having a higher prevalence of hypertension, sleep apnea and metabolic syndrome. There is no conclusive evidence yet that the syndrome increases cardiovascular mortality, but indirect risk markers – such as carotid artery thickness and calcium score – tend to be higher in this group.
“These patients deserve a detailed cardiovascular risk assessment, including metabolic, liver function and sleep apnea tests. It is also important to apply updated risk scores, such as the new equation Impedewhich considers broader parameters, including microalbuminuria, lipoprotein A and C-reactive protein,” advises Larissa.
Progress in treatment and future prospects
According to the specialist, the big news in the clinical management of PCOS in this age group is the use of GLP-1 agonists and double or triple agonists, drugs originally indicated for diabetes and obesity, but which show potential to improve metabolism.
“These drugs are excellent candidates for the treatment of women with polycystic ovary syndrome and at high metabolic risk. Studies in animal models have shown improvements in both metabolic parameters and reproductive function,” he comments.
The doctor reiterates, however, the importance of a careful diagnosis, avoiding labeling patients exclusively on the basis of ultrasound.
“It is essential to confirm the diagnosis in childbearing age, as it guides lifelong monitoring. Once identified, PCOS should be considered an additional cardiovascular risk factor, guiding the degree of investigation and the intensity of preventive measures”, concludes the endocrinologist.
Source: Terra
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