Beyond the Ovaries: Can PCOS/PMOS Increase a Woman’s Risk of Stroke? What Filipino Women Need to Know -

You may be watching your menstrual cycle, worrying about your weight, or trying to understand why your hormones seem to be working against you but have you ever thought about what PCOS could mean for your heart and brain?

Imagine a woman in her early thirties. She works every day, takes care of her family, tries to eat healthier, and manages the unpredictable symptoms of PCOS. Some months, her period doesn’t come. She experiences fatigue, weight changes, and perhaps difficulty losing weight despite her efforts.

She knows she needs to pay attention to her reproductive health. She might even be taking medication or following a treatment plan but when was the last time she checked her blood pressure?

When did she last have her cholesterol tested?

Has anyone ever explained to her that the condition affecting her hormones may also have implications for her cardiovascular health?

For many women, the answer is probably not recently enough.

PCOS has long been discussed in conversations about irregular menstruation, fertility, acne, unwanted hair growth, and weight management. These are important concerns. But they are only part of a much bigger picture.

In 2026, new scientific publications have brought renewed attention to the relationship between Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS), and cardiovascular disease.

Among the concerns is stroke. This isn’t a reason to panic. Having PCOS does not mean that you will eventually experience a stroke but research is revealing something that women, families, and healthcare professionals should take seriously. The conversation about PCOS needs to go beyond the ovaries.

It needs to include the heart, the blood vessels, and the brain.

Why are we talking about stroke now?

October 29 marks World Stroke Day, an international campaign led by the World Stroke Organization to raise awareness about stroke prevention, early recognition, and timely treatment.

The 2026 campaign carries an important message: Every M1nute Counts.

The message reminds us that recognizing stroke symptoms and getting emergency treatment quickly can save lives. World Stroke Organization but stroke awareness should not begin only when someone experiences symptoms. It should also include conversations about prevention, particularly among people who may have underlying health conditions that influence cardiovascular risk.

This is where PMOS deserves attention.

Stroke is not a distant health concern for Filipinos

According to the Philippine Statistics Authority’s October 28, 2026 provisional report, cerebrovascular diseases ranked as the third leading underlying cause of death in the Philippines from January to April 2026.

Philippines, January–April 2026

16,865

Recorded deaths from cerebrovascular diseases

9.3%

Of all recorded deaths during the reporting period

Source: Philippine Statistics Authority, 2026 Underlying Causes of Death, provisional data as of August 31, 2026. Philippine Statistics Authority

These figures are provisional and refer to cerebrovascular diseases as a broader category, not exclusively ischemic stroke. Still, they tell us something important. Stroke-related conditions are a serious public health concern in the Philippines and Filipino women should be part of this conversation.

What exactly is PMOS, and why does the name matter?

For decades, the condition was commonly known as Polycystic Ovary Syndrome or PCOS.

The name often led women to believe that the condition was primarily about ovarian cysts and reproductive problems but PCOS is much more complicated. It involves interactions between reproductive hormones, metabolic processes, and endocrine function. The newer term, Polyendocrine Metabolic Ovarian Syndrome (PMOS), is intended to better reflect these interconnected features.

In 2026, the terminology transition received significant international attention, including updated international guideline work and publications involving the World Health Organization and endocrine specialists. Penn Medicine+1

Why is this important?

Because women should understand that PMOS is not simply a condition affecting menstruation or the ability to become pregnant.

It can also involve:

Insulin resistance and glucose intolerance.
Increased risk of type 2 diabetes.
Abnormal cholesterol levels.
High blood pressure.
Sleep-related metabolic problems.
Long-term cardiovascular health concerns.

Not every woman with PMOS experiences all these problems. Some have significant metabolic complications, while others have relatively normal metabolic measurements but the condition deserves comprehensive care, even when the most visible symptoms appear to be reproductive.

The research: Is there really a connection between PCOS/PMOS and stroke?

The short answer is yes.

Several studies have found an association. The more important question is how strong that association is, what it means, and whether the evidence proves that PMOS directly causes stroke.

Let’s examine the research.

1. The 2024 meta-analysis: More than one million women studied

A study by Tay and colleagues, published in the Journal of the American Heart Association in August 2024, examined cardiovascular outcomes among women with PCOS.

The systematic review included 20 studies involving approximately 1.06 million women:

369,317 women with PCOS.
692,963 women without PCOS.

The researchers reported an odds ratio of 1.71 for stroke among women with PCOS compared with women without PCOS.

This means the pooled odds of stroke were higher in the PCOS group but the researchers also reported substantial differences between the included studies. The results should not be interpreted as an exact prediction of an individual woman’s risk.

The findings helped inform the 2023 International Evidence-Based PCOS Guideline, which recommends greater awareness of cardiovascular risk and comprehensive assessment. PubMed

2. The 2025 systematic review: PCOS and stroke risk beyond body weight

A systematic review and meta-analysis published in BMC Women’s Health on August 5, 2025, examined the relationship between PCOS, hypertension, stroke, and cardiovascular disease.

It included:

33 studies on hypertension.
10 studies on stroke.
26 studies on cardiovascular disease.

The pooled relative risk of stroke was 1.28, with a 95% confidence interval of 1.10–1.49.

The authors also reported that the association between PCOS and stroke remained when BMI was considered in their analyses. Springer Nature Link

This finding matters because it challenges the idea that cardiovascular concerns in PCOS are exclusively about body weight. A woman can have a normal BMI and still experience metabolic abnormalities.

Her weight alone cannot tell us whether her blood pressure, glucose regulation, or cholesterol levels are healthy.

3. The July 2026 study: A major development using the PMOS name

Important 2026 research

One of the most significant recent developments came from researchers affiliated with the University of Pennsylvania and the University of Rochester.

The study was published in The Lancet Obstetrics, Gynaecology & Women’s Health on July 20, 2026.

Its title is:

* Atherosclerotic cardiovascular disease risk in polyendocrine metabolic ovarian syndrome: a nationwide, US, claims-based, retrospective, longitudinal, cohort study.*

The study included:

413,450 women in the PMOS group.
2,067,250 women in the comparison group.
A total of approximately 2.48 million participants.

The average age was approximately 31 years.

Adjusted hazard ratio for composite ASCVD

4.40

95% CI: 4.23–4.58

The PMOS group had a substantially higher rate of the combined outcome of coronary artery disease, cerebrovascular disease, and peripheral artery disease compared with the reference group.

Alur-Gupta et al., 2026, The Lancet Obstetrics, Gynaecology & Women’s Health. DOI: 10.1016/S3050-5038(26)00090-7. DOI+1

This result deserves attention, but we need to interpret it correctly.

The 4.40 figure is for the combined cardiovascular outcome. It is not the stroke-only risk.

Penn Medicine’s report of the same study stated that, after adjustment for other risk factors, the PMOS group was approximately 2.5 times more likely to experience a heart attack or stroke during the study period. The study also found an increased risk of transient ischemic attack (TIA), approximately 3.4 times that of the comparison group. Penn Medicine

This is an important development because the research examined PMOS using the newer terminology while highlighting the cardiovascular implications of the condition.

It also reinforces the need to look beyond reproductive symptoms when discussing long-term women’s health.

But there is a limitation: This was a retrospective study using US health insurance claims. PMOS identification relied on diagnostic codes and, in some cases, a combination of irregular menstruation and hirsutism. It was not a study in which every participant underwent the same comprehensive clinical diagnostic examination.

The findings also cannot automatically be transferred to Filipino women. We need comparable Philippine studies.

4. The September 2026 Danish study: Long-term risk of ischemic stroke

Another important study was published on September 22, 2026, in the European Journal of Preventive Cardiology.

Havers-Borgersen and colleagues examined Danish nationwide health registry data.

The study included:

25,513 women diagnosed with PCOS.
102,052 matched women in the comparison group.

The researchers examined the long-term risk of acute myocardial infarction and ischemic stroke.

Adjusted hazard ratio for ischemic stroke

1.56

95% CI: 1.27–1.91

The PCOS group had a higher associated risk of ischemic stroke after statistical adjustment.

Havers-Borgersen et al., 2026. DOI: 10.1093/eurjpc/zwaf351. PubMed

The researchers also reported that the 25-year cumulative incidence of the combined outcome of heart attack and ischemic stroke was 3.4% in women with PCOS, compared with 2.0% in the control group.

Notice that these percentages refer to the combined outcome, not stroke alone.

This distinction matters because research should inform women, not frighten them with misleading statistics.

Taken together, these studies provide growing evidence of a relationship between PCOS/PMOS and cardiovascular complications, including ischemic stroke.

They do not prove that every woman with PMOS will develop cardiovascular disease.

And they do not establish that PMOS is the sole cause of stroke.

Why might PMOS affect the heart and brain?

To understand the connection, we need to look at what happens inside the body.

PMOS is not just about reproductive hormones. Several metabolic and vascular processes may overlap and influence cardiovascular health.

1. Insulin resistance: When the body struggles to use insulin

Why Insulin Resistance and Diabetes Are the Top Predictors of Heart Disease and Death

Insulin helps move glucose from the bloodstream into cells so the body can use it for energy. In insulin resistance, the body’s cells do not respond to insulin as effectively as they should. The pancreas may compensate by producing more insulin.

This can contribute to several metabolic problems, including:

Higher circulating insulin levels.
Increased risk of impaired glucose tolerance.
Increased risk of type 2 diabetes.
Changes in lipid metabolism.
Interactions with androgen production.

Over time, insulin resistance and related metabolic abnormalities can contribute to cardiovascular risk.

For Filipino women, this is particularly relevant because insulin resistance can exist even when fasting blood glucose appears normal. A woman may feel tired, experience irregular periods, or struggle with weight changes without realizing that her glucose regulation needs further assessment.

One important distinction: insulin resistance is a recognized part of PCOS pathophysiology, but it does not mean that every woman with PCOS has diabetes or will develop a stroke.

2. High blood pressure: A risk factor that should never be ignored

What Causes High Blood Pressure?

High blood pressure, or hypertension, is one of the most important modifiable risk factors for stroke. When blood pressure remains elevated over time, it places additional stress on blood vessel walls.

This can contribute to damage in the arteries and increase the risk of:

Ischemic stroke, when a blood vessel supplying the brain becomes blocked.
Hemorrhagic stroke, when a blood vessel ruptures and causes bleeding in or around the brain.

The 2025 PCOS meta-analysis found a pooled relative risk of hypertension of 1.45 among women with PCOS compared with women without PCOS. Springer Nature Link This is one reason blood pressure monitoring should be part of comprehensive PMOS care.

A woman should not wait until she experiences a headache or dizziness before checking her blood pressure. Hypertension often has no obvious symptoms.

3. Abnormal cholesterol and atherosclerosis

Difference Between Atherosclerosis and Arteriosclerosis

Cholesterol is essential for normal body function, but abnormal levels of blood lipids can contribute to cardiovascular disease. Some women with PMOS experience:

Elevated LDL cholesterol.
Reduced HDL cholesterol.
Elevated triglycerides.

When cholesterol-rich particles accumulate in artery walls, atherosclerotic plaque can develop. If plaque narrows an artery or contributes to a blood clot, blood flow to the brain may become blocked.

This can result in an ischemic stroke.

It is important to understand that not every woman with PMOS has dyslipidemia. A lipid profile is needed to assess an individual’s levels.

4. Endothelial dysfunction and inflammation

The endothelium is the thin layer of cells lining blood vessels.

It helps regulate blood flow, vessel relaxation, and other functions that keep the circulatory system healthy. Some research involving women with PCOS has identified impaired endothelial function and elevated inflammatory markers.

These findings provide possible explanations for why metabolic and hormonal abnormalities may be associated with vascular problems but there is an important distinction. Endothelial dysfunction and inflammation are possible biological pathways. They are not proof that a particular woman will experience a stroke.

More research is needed to determine how much each mechanism contributes to actual stroke events in women with PMOS.

Does this mean even young Filipino women with PMOS are at risk?

This is a question worth taking seriously.

Stroke is often associated with older adults, but cardiovascular risk factors can develop much earlier in life. Consider the realities of many Filipino women. A woman may work eight to ten hours a day, spend hours commuting, care for her children, and manage household responsibilities.

She may skip meals, rely on convenient food, get insufficient sleep, and postpone medical appointments because of financial or time constraints. Some women may also experience delayed PCOS diagnosis because irregular periods, acne, or weight changes are dismissed as normal hormonal problems.

These circumstances do not automatically cause stroke. But they can make it harder to identify and manage existing health risks and PMOS may add another layer of complexity.

What about women with normal weight?

A common misconception is that cardiovascular concerns only apply to women with obesity.

That is not supported by the available research. The 2025 meta-analysis reported an association between PCOS and stroke even after considering BMI. This means normal weight should not be treated as proof of normal metabolic health. A woman who looks healthy may still have elevated blood pressure, abnormal cholesterol, or impaired glucose tolerance.

Health cannot be measured by appearance alone.

What about women who have never been diagnosed?

This is another overlooked issue.

The studies we discussed primarily identified PCOS/PMOS through medical records, diagnostic criteria, or healthcare coding that means they do not necessarily capture every woman who has the condition but has never received a diagnosis.

Some women in comparison groups may also have undiagnosed PCOS.

The University of Pennsylvania’s 2026 report highlights that PMOS is frequently unrecognized, citing an estimated 70% of affected women who are unaware of their condition. Penn Medicine

For Filipino women, this raises an important question:

How many women are experiencing irregular menstruation, excessive hair growth, metabolic problems, or other possible PMOS symptoms without knowing that they should seek an appropriate assessment?

We do not currently have sufficient Philippine-specific data to answer that question accurately but it is a question that deserves attention from healthcare professionals, researchers, and women’s health organizations.

What should Filipino women with PCOS/PMOS do to protect their cardiovascular health?

The good news is that having PMOS does not mean giving up on your long-term health.

Many cardiovascular risk factors can be identified and managed. The first step is knowing what to monitor. The 2023 International Evidence-Based PCOS Guideline recommends cardiovascular risk assessment for women with PCOS.

A realistic approach for Filipinas

You do not need an expensive diet or complicated wellness routine to start caring for your cardiovascular health. Start with practical changes.

Food and nutrition

Include vegetables and fiber-rich foods in everyday meals.
Choose fish, beans, and other suitable protein sources.
Pay attention to portions of rice and other refined carbohydrates.
Limit excessive sodium, particularly from processed foods and salty condiments.
Reduce sugary drinks and frequent consumption of highly processed food.

Rice does not need to be completely eliminated. The goal is a balanced eating pattern that you can maintain.

Movement

Start with walking, even if it is only for short periods.
Break up long periods of sitting.
Gradually build toward regular physical activity.
Choose activities that fit your schedule and physical abilities.

Sleep and stress

Aim for consistent sleep.
Pay attention to persistent fatigue and possible sleep apnea.
Seek professional support when stress becomes difficult to manage.

Medical follow-up

Do not discontinue prescribed medication or start supplements based on social media advice. Discuss your individual treatment options with your healthcare provider.

The goal is not perfection. It is consistent, sustainable care.

Can PMOS cause a stroke directly?

This is where we need to be scientifically honest.

The available studies show an association between PMOS/PCOS and increased cardiovascular and stroke-related outcomes. There are plausible biological explanations involving insulin resistance, hypertension, dyslipidemia, and vascular dysfunction but observational research cannot establish that PMOS directly causes stroke.

Other factors, including age, diabetes, smoking, blood pressure, cholesterol, family history, and socioeconomic circumstances, can also influence cardiovascular outcomes.

The research is encouraging enough to justify earlier attention to cardiovascular health, but it is not a reason to tell every woman with PMOS that she will have a stroke.

Awareness should lead to prevention, not fear.

Know the warning signs: BE FAST

Whether you have PMOS or not, knowing the warning signs of stroke could save someone’s life.

Remember BE FAST:

Letter	Warning sign
B – Balance	Sudden loss of balance or coordination
E – Eyes	Sudden vision changes or loss of vision
F – Face	One side of the face droops
A – Arms	Sudden weakness or numbness, especially on one side
S – Speech	Difficulty speaking or understanding speech
T – Time	Call emergency services immediately

If these symptoms occur, call 911 in the Philippines or seek emergency care immediately.

Do not wait for symptoms to disappear. Do not attempt to treat a suspected stroke at home.

A transient ischemic attack (TIA), sometimes called a mini-stroke, also requires urgent medical assessment even if the symptoms resolve.

Every minute matters.

Why PCOS Millennials believes this conversation matters

At PCOS Millennials, we believe women deserve more than a diagnosis and a list of symptoms.

They deserve to understand what is happening inside their bodies. For years, many women have been told to focus on their menstrual cycles, lose weight, or simply wait for their hormones to improve. Some have spent years searching for answers.

Others have struggled to get a proper diagnosis.

Many have never been informed about the potential metabolic implications of their condition. We believe that needs to change. Our work focuses on making PCOS/PMOS education more accessible, encouraging early awareness, and helping women become more informed participants in their own healthcare. Through our educational platform, community initiatives, and self-assessment resources, we want to make important health information easier to understand, particularly for women who may not have regular access to specialist care.

A woman with PMOS should not have to wait until she develops diabetes, hypertension, or a cardiovascular complication before someone starts talking to her about long-term health.

The emerging research gives us a reason to ask better questions, improve screening practices, and make cardiovascular education part of the wider PCOS conversation. For Filipino women, this is particularly important. We need more accessible healthcare education, more early assessments, more research involving Filipino populations, and stronger collaboration between reproductive health specialists, endocrinologists, cardiologists, and neurologists.

Most importantly, women need to know that their health is bigger than their menstrual cycle, their fertility, or the number on a weighing scale.

Your ovaries are part of your health story. They are not the whole story and understanding that story could make a difference for the years ahead. You deserve to live a healthier life, with the knowledge and support to make informed decisions about your body.

You are not alone. PCOS Millennials is here to help make that conversation happen.

Frequently Asked Questions About PCOS/PMOS and Stroke

These questions are included to help readers find clear answers to common concerns about PMOS and cardiovascular health.

1. Does PCOS increase the risk of stroke?

Research suggests that women with PCOS may have an increased risk of stroke compared with women without the condition. Several meta-analyses and population studies have reported this association. However, PCOS has not been established as a direct cause of stroke.

2. Can women with PMOS experience a stroke even if they are young?

Yes. Stroke can happen in younger adults. Having PMOS does not mean a woman will experience a stroke, but cardiovascular risk factors can develop during reproductive years and deserve attention.

3. Does insulin resistance increase stroke risk?

Insulin resistance is associated with several cardiometabolic abnormalities, including glucose intolerance, type 2 diabetes, and changes in lipid metabolism. These can contribute to cardiovascular risk. Insulin resistance alone does not mean that someone will have a stroke.

4. Can a woman with normal weight and PCOS have cardiovascular problems?

Yes. BMI alone cannot determine cardiovascular health. Women with normal BMI may still have hypertension, insulin resistance, or abnormal cholesterol levels.

5. What medical tests should women with PMOS consider?

The 2023 international guideline recommends cardiovascular risk assessment, including blood pressure measurement, lipid profiling, and glucose assessment. A 75-g OGTT is the most accurate recommended test for glycemic status in PCOS.

6. Is PMOS the same condition as PCOS?

PMOS is the newer name proposed for the condition previously known as PCOS. The terminology emphasizes its broader endocrine and metabolic features. Many historical research papers and medical records still use PCOS, so both terms are important when searching for scientific evidence.

7. Is there research specifically involving Filipino women with PMOS and stroke?

There is a need for more large-scale Philippine studies specifically examining this relationship. International research provides important evidence, but its numerical estimates should not automatically be applied to Filipino women.

Scientific references and research sources

These are the primary publications and institutional sources used in preparing this article. They can be linked at the bottom of the published blog for readers, healthcare professionals, and researchers.

Major research studies

1. Alur-Gupta S, et al. (2026). Atherosclerotic cardiovascular disease risk in polyendocrine metabolic ovarian syndrome: a nationwide, US, claims-based, retrospective, longitudinal, cohort study. The Lancet Obstetrics, Gynaecology & Women’s Health, 2, e699–e708.
Read the original Lancet study. DOI: 10.1016/S3050-5038(26)00090-7.

2. Havers-Borgersen E, et al. (2026). Polycystic ovarian syndrome and long-term risk of acute myocardial infarction and ischaemic stroke. European Journal of Preventive Cardiology, 33(13), 2444–2451.
Read on PubMed. DOI: 10.1093/eurjpc/zwaf351.

3. Pourahmad B, et al. (2025). Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis. BMC Women’s Health, 25, 385.
Read the open-access study.

4. Tay CT, et al. (2024). 2023 International Evidence-Based Polycystic Ovary Syndrome Guideline Update: Insights From a Systematic Review and Meta-Analysis on Elevated Clinical Cardiovascular Disease in Polycystic Ovary Syndrome. Journal of the American Heart Association, 13(16), e033572.
Read on PubMed. DOI: 10.1161/JAHA.123.033572.

Clinical guidelines and institutional sources

5. Teede HJ, et al. (2023). Recommendations from the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.
Read the international clinical guideline.

6. Monash University (2026). International Evidence-Based Guideline for the Assessment and Management of Polyendocrine Metabolic Ovarian Syndrome.
Access the updated PMOS guideline.

7. Penn Medicine (July 20, 2026). PMOS, formerly PCOS, raises risk of atherosclerotic cardiovascular disease, heart attacks, strokes.
Read the institutional research announcement.

Philippine and international stroke information

8. Philippine Statistics Authority (October 28, 2026). 2026 Underlying Causes of Death in the Philippines, provisional as of August 31, 2026.
Read the official Philippine statistics.

9. World Stroke Organization (2026). World Stroke Day 2026 – Every M1nute Counts.
World Stroke Day campaign and resources.