15
9. Polycystic Ovary Syndrome
Lipid Abnormalities
➤ 9.1 In women with polycystic ovary syndrome (PCOS), we recommend
obtaining a fasting screening lipid panel at diagnosis to assess CV risk.
(1|⊕⊕⊕
)
Technical Remarks:
▶ PCOS is associated with CV risk factors.
▶ Conduct lipid screening both before and intermittently during hormonal therapy.
▶ In PCOS, hypertriglyceridemia is the most common lipid abnormality.
Cardiovascular Risk
Effect of treatment of PCOS on lipids
➤ 9.2 In women with PCOS, we suggest against using lipid-lowering therapies
to treat hyperandrogenism or infertility. (2|⊕
)
10. Menopause And Hormonal Replacement
➤ 10.1 In postmenopausal women, we recommend treating dyslipidemia with
statin therapy, rather than hormone therapy. (1|⊕⊕
)
Technical Remarks:
▶ Hormone therapy increases the risk of CVD, specifically venous thromboembolism
and stroke. However, the absolute risk of CVD is lower in younger compared to older
postmenopausal women.
▶ Hormone therapy is described as estrogen +/– progesterone/a progestin.
➤ 10.2 In postmenopausal women on hormone therapy and with other risk
factors for CVD, we recommend statin therapy to reduce CV risk. (1|⊕⊕⊕⊕)
Technical Remarks:
▶ Hormone therapy increases the risk of CVD, specifically venous thromboembolism
and stroke. However, the absolute risk of CVD is lower in younger compared to older
postmenopausal women.
▶ Hormone therapy is described as estrogen +/– progesterone/a progestin.
▶ Menopause may be associated with an increase in LDL-C and a decrease in HDL-C.
▶ Risk factors may be traditional risk factors or risk-enhancing factors.
➤ 10.3 In women who enter menopause early (<40–45 years old), we
recommend assessment and treatment of lipids and other CV risk factors.
(1|⊕⊕⊕
)
Technical Remarks:
▶ Early menopause enhances CVD risk.
▶ ASCVD risk should be calculated and followed after menopause.
