Proceedings · May 11, 2026

Hormonal therapy and cardiovascular risk in polycystic ovary syndrome: a propensity-matched cohort study

By Varma R, Ilelaboye A, Ugwuja F et al.

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular disease risk. Hormonal therapy is a cornerstone of PCOS management, yet its long-term cardiovascular safety remains uncertain. METHODS: This retrospective cohort study using TriNetX included adult women with PCOS stratified by hormonal therapy initiation within 1 month of diagnosis versus never receiving therapy. One-to-one propensity score matching was performed. The primary outcome was major adverse cardiovascular events (MACE). Cox proportional hazards models estimated hazard ratios (HRs). RESULTS: After matching, 104,849 patients were included per cohort. Over 1-year follow-up, hormonal therapy was associated with a lower risk of MACE (hazard ratio [HR] 0.72; 95% confidence interval 0.62-0.83), all-cause mortality (HR 0.68; 0.57-0.80), hospitalization (HR 0.55; 0.54-0.57), and atrial fibrillation (HR 0.76; 0.62-0.94) (all P < 0.001). Risks of myocardial infarction, stroke, heart failure, arrhythmias, and venous thromboembolism were similar between groups. CONCLUSIONS: Hormonal therapy in PCOS was associated with reduced MACE, mortality, and hospitalization without increased thrombotic or arrhythmic risk, supporting cardiovascular safety and potential cardioprotective effects.

doi.org/10.1080/08998280.2026.2667116 Open access PubMed 42269075 Interventions