Beyond Fertility And Acne: Why Women With PMOS Face A 32% Higher Risk Of Cardiovascular Diseases
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PMOS now includes long-term endocrine and cardiovascular health impact, one that may significantly increase the risk of hypertension, insulin resistance, obesity among young women.
According to WHO figures, approximately 220 million people in India suffer from hypertension, yet only around 12% receive proper treatment.
For millions of women in India, polycystic ovary syndrome, commonly known as PCOS, often begins as a deeply personal struggle. PCOS now officially renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) – a change that better reflects its complex endocrine and metabolic nature, may start with irregular periods in adolescence, stubborn acne in college years, sudden weight fluctuations, fertility concerns after marriage, or the emotional exhaustion that comes from living in a body that feels unpredictable.
For years, these symptoms have largely been treated in isolation, viewed as reproductive or hormonal concerns rather than warning signs of something potentially far more serious. Across India’s cities, where sedentary lifestyles, high stress levels, disrupted sleep cycles, processed diets, and long working hours have quietly become the norm, doctors are increasingly observing how PMOS is intersecting with a much broader metabolic crisis.
What was once considered primarily a gynaecological condition is now includes long-term endocrine and cardiovascular health impact, one that may significantly increase the risk of hypertension, insulin resistance, obesity, and heart disease among younger women.
In an insightful discussion, Dr Harshal Chaudhari, Head Medical Affairs – CM&E Merck India and Associate Director – Cardiology & Thyroid Merck APAC, highlights the evolving perspective, “India is currently seeing a change in how women’s health is perceived. Previously, conditions that were primarily reproductive are now increasingly being looked at as chronic metabolic or cardiovascular diseases. One of the first examples of this is polycystic ovary syndrome (PCOS), now known as PMOS.”
A 2025 study published in the journal Reproductive Health points to a rising prevalence of PMOS among young women in the Delhi-NCR region, alongside growing metabolic concerns in urban India.
In another large-scale study published in the European Journal of Endocrinology has added fresh urgency to concerns surrounding PMOS and long-term heart health. The researchers examined national health registry data involving nearly 128,000 women diagnosed with PMOS and compared their health outcomes with more than 587,000 women without the condition.
The findings were striking- overall, women living with PMOS were found to have a 32% higher risk of developing cardiovascular disease compared to women without the condition.
However, one observation particularly challenged long-standing assumptions around cardiovascular risk. Even women with PMOS who had a body mass index (BMI) below 25 and did not have type 2 diabetes still faced a 40 per cent higher risk of cardiovascular disease.
At the same time, cardiovascular problems remain the leading cause of mortality in the country, accounting for nearly 31% of all deaths according to the latest Sample Registration System (SRS) data from 2025.
Why PMOS Is No Longer Just About Hormones
Dr Chaudhari explains the underlying mechanisms, “Disruption of the autonomic system could contribute to cardiovascular disease in PMOS due to its impact not only on the regulation of blood pressure but also on sex hormone secretion from the ovaries. Although recent research is constrained by a small sample size and a single time point, there is evidence that sympathetic tone is elevated and parasympathetic regulation of heart rate is impaired in PMOS.”
According to WHO figures, approximately 220 million people in India suffer from hypertension, yet only around 12% receive proper treatment. Despite these statistics, the cardiovascular implications of PMOS have rarely featured in broader discussions on women’s health.
“Women under the age of 40 continue to be viewed as a low-risk demographic, causing delays in treatment,” Dr. Chaudhari points out. “For many women, their high blood pressure is often detected as a reaction instead of prevention.”
That reality becomes even more concerning against the backdrop of modern urban lifestyles. Desk-bound work cultures, chronic stress, poor sleep hygiene, processed food consumption, and declining physical activity are all contributing to rising metabolic disease among younger Indians, particularly in cities.
PMOS Beyond Reproductive Health
Historically, conversations around PMOS (formerly PCOS) have focused on fertility issues, menstrual irregularities, acne, and weight gain. These remain important, but Dr Chaudhari stresses a wider view, “Recent studies have found PMOS to be an endocrine disorder with metabolic implications involving insulin resistance, inflammation, obesity, dyslipidaemia, and high blood pressure. All of these aspects contribute to the premature onset of cardiovascular risks.”
Age-related biases compound the challenge. Women under 40 are often considered low-risk for hypertension, leading to delayed screening and reactive rather than preventive care. In India’s rapidly urbanising environment – marked by desk-bound jobs, chronic stress, poor sleep, and shifting dietary habits – young women face heightened metabolic risks.
Some of the most important lifestyle modifications now recommended for improving heart health in PMOS include:
- Maintaining a healthy body weight through sustainable eating habits and regular movement
- Prioritising fibre-rich whole foods while reducing processed and high-sugar foods
- Including lean proteins, omega-3-rich foods, nuts, seeds, fruits, and vegetables in daily meals
- Monitoring cholesterol, blood pressure, and blood sugar levels regularly
- Engaging in consistent physical activity such as walking, cycling, strength training, yoga, Pilates, or HIIT workouts
- Managing stress through mindfulness practices, meditation, hobbies, therapy, or adequate rest
- Improving sleep hygiene and hydration levels
- Scheduling regular health screenings to identify cardiovascular risks early
Do Women Pay The Cost of Fragmented Care?
One of the most pressing issues is fragmented healthcare. Women with PMOS might consult a gynaecologist for menstrual problems, a dermatologist for skin concerns, and a nutritionist for weight management, yet cardiovascular risk assessment is frequently overlooked. “By the time hypertension develops, it may already be too late,” notes Dr Chaudhari.
He advocates for greater integration, “There is a need for an integrated approach where endocrinology, cardiology, gynaecology, diagnostics, and preventive medicine are better synchronised.”
