Can PCOS Cause High Cholesterol?

Can PCOS Cause High Cholesterol? - Zizi

Medically Reviewed by Vincenta Faulkner, RD, CNSC, CCTD

If you have the hormonal disorder polycystic ovary syndrome (PCOS), your reproductive health may not be the only thing you have cause for concern about. This syndrome may also increase your risk for other medical conditions, including diabetes, high blood pressure, high cholesterol, and obesity, all of which can put you at a greater risk for heart disease. 

Here, we discuss PCOS and its associated causes, symptoms, and effects, including its association with high cholesterol levels. 

Let’s explore more about PCOS and cholesterol with Zizi below. 

What Is PCOS?

While PCOS, or polycystic ovary syndrome (sometimes referred to as polycystic ovarian syndrome), is a complex hormonal disorder, at its most high-level overview, it’s a condition that affects the balance of male and female sex hormones in a female’s body. 

Androgen comprises a group of sex hormones that help with your body’s puberty and development processes, and while both sexes produce androgen, males naturally produce much more. If you haven’t heard of androgen, chances are you have heard of testosterone, which is the most common type of androgen. 

In the male reproductive system, androgens derive from the testicles, whereas androgens derive from the ovaries in the female reproductive system. 

Females naturally convert androgen into another hormone called estradiol. This hormone, which comprises a form of estrogen, is involved in the menstrual cycle, fertility, body development, and skeletal structure. 

If a female has PCOS, there is an imbalance in the conversion of these hormones that can result in a variety of outcomes in different parts of the body. 

In terms of reproductive health, it can affect menstrual cycle timing and a female’s ability to ovulate, which can result in the growth of cysts on the ovaries.

For metabolic health, it can affect insulin’s ability to move glucose out of the bloodstream, which is why some females take metformin, a diabetes drug, to help them manage their blood sugar levels even though they aren’t diabetic. 

For cardiovascular health, excess weight gain and high BMI levels caused by dysregulation of hormones and underperforming insulin can mean higher visceral fat, which can lead to higher triglycerides, lower HDL, and higher LDL. 

What Causes PCOS?

The exact cause for this hormonal unbalance remains unknown, although likely a combination of genetic and environmental factors plays a role. 

If you have PCOS, it is not uncommon that someone else in your family does as well, and because this disorder runs in families, genetics likely in part cause the disorder. There could also be various environmental factors that influence your hormonal imbalance and androgen overproduction, but not enough research exists to pinpoint an exact cause of this disorder yet. 

What Are the Symptoms of PCOS?

Because androgen comprises a form of estrogen and is involved in the female menstrual cycle, fertility, body development, and skeletal structure’s sustainability, PCOS affects all of these factors.

If you have PCOS, you likely present with two or more of the following effects: no ovulation, excess androgen levels, and cysts on one or both ovaries. When you do not ovulate, it greatly affects your periods, so if you have PCOS, you may notice either very irregular periods or even no periods at all for several months at a time. 

PCOS also affects your body’s physical development, and people with PCOS often develop acne, more body hair than normal, or body hair in places where females usually do not have hair. You may also experience weight gain around the abdominal area or hair loss on your scalp.

Additionally, as you do not ovulate, you may, unfortunately, struggle with infertility. 

How Does PCOS Affect My Heart Health?

A hormonal imbalance is not the only disorienting effect of PCOS — a variety of different studies suggest an association between PCOS and dyslipidemia, or an imbalance of lipids (aka fats, including triglycerides and cholesterol). 

Up to 70% of people with PCOS may have some form of high cholesterol levels. 

PCOS could potentially affect your lipid levels in general, which means that if you have PCOS, you could have increased LDL levels and decreased HDL, increased VLDL, and increased triglyceride levels. 

In particular, increased LDL levels are a noteworthy association with PCOS because LDL can result in atherosclerosis, which occurs when lipid plaque deposits on your artery walls. This plaque can lead to narrowed or hardened arteries that may eventually lead to blockage. 

As such, if you have PCOS and, in turn, have high LDL cholesterol levels, you may be at a much greater risk for heart disease. 

PCOS and High Cholesterol: Causes

If you have PCOS and high cholesterol levels, there is likely a combination of factors at play that prompt this dyslipidemia. These factors include obesity, imbalanced hormone levels, and insulin resistance. 

Researchers are still unsure how much stems from one factor as opposed to another — your PCOS could also derive from a combination or interaction of more than one factor. This is to say that the exact cause, or causes, for high cholesterol if you have PCOS is still not clear. Let’s look at some of the potential factors below. 


If you have PCOS, you might experience obesity as a common side effect. Obesity can impact cholesterol levels, particularly triglyceride levels. 

When you are obese, more free fatty acid (FFA) flows to your liver, which causes triglyceride level increases. This also leads to VLDL level increases, and can ultimately lower your good, or HDL, cholesterol levels as well. Obesity is also often associated with insulin resistance, which we discuss below as another adverse influence on cholesterol levels. 

Insulin Resistance

Insulin resistance occurs when your body has a hard time abstracting glucose from your bloodstream to convert to energy. In response, your body tries to compensate and subsequently produces more insulin. However, instead of regulating your blood sugar levels, which your body intends as a result, your body instead overproduces insulin to the point where it builds up. 

Excess insulin, in turn, leads to weight gain: insulin increases can inhibit hormone-sensitive lipase (HSL), which plays a leading role when it comes to hydrolyzing intracellular lipids. Inhibiting HSL causes fat buildup, especially in the abdomen area, which causes more belly fat, also known as visceral fat, to appear. Visceral fat buildup can ultimately lead to higher triglyceride levels and lower HDL levels. 

Imbalanced Hormone Levels

Your body uses the cholesterol that it naturally produces in your liver in part to make hormones such as androgen. 

Since PCOS means excess androgen levels, this hormonal imbalance likely plays a role in elevated cholesterol levels, although more research is still needed to discern the exact pathophysiology behind this. 

I Have PCOS and High Cholesterol — What Should I Do?

While you cannot change PCOS, you can change your cholesterol levels. Some top ways to target your high cholesterol levels naturally, without medication, are as follows. 

Eat a Well-Balanced, Healthier Diet

Include more heart-healthy food sources in your diet, such as soluble fiber as well as mono and polyunsaturated fats. Foods rich in soluble fiber that you could easily incorporate into your diet include oats, barley, whole grains, vegetables, apples, and beans. Soluble fiber helps lower your LDL cholesterol levels. 

Foods rich in mono and polyunsaturated fats include avocado, nuts, fish, and vegetable and plant oils. Unsaturated fats also help lower your cholesterol by reducing your LDL levels. 

At the same time, you should try to limit your saturated fat intake. Foods with a high saturated fat content that you may want to avoid include processed meats and full-fat dairy products. You may also want to limit your palm and coconut oil intake. 

Manage Your Weight, Target Your Obesity

Because obesity is a leading contributor to high cholesterol levels, losing even a small amount of weight can significantly affect your cholesterol levels, especially in your LDL levels. 

Remember, every little bit counts. You have to start somewhere, and any step in the right direction, no matter how small, is still progress. 

Your starting point is already a great way to see reductions in your cholesterol levels for a happier, healthier you. 

Live an Active Lifestyle

Exercise can both raise your good, or HDL, cholesterol levels which at the same time reduce your bad, or LDL, levels. Try to make it a point to get active four to five times a week, each time for thirty minutes or more. 

Drink Less Alcohol and Don’t Smoke

While consuming alcohol in moderation is perfectly fine, excess consumption can increase your cholesterol levels. Alcohol also contains a lot of sugar and calories, so it can further contribute to weight gain. Both smoking and alcohol consumption can raise your cholesterol levels. 

The Simplest Path to the Care You Deserve

If you have PCOS, you may be at an increased risk for heart disease because PCOS can sometimes cause high cholesterol. While researchers are still unsure of the exact precursor to high cholesterol levels, several factors, including obesity, insulin resistance, and imbalanced hormone levels, likely influence your cholesterol test results. 

Luckily, Zizi is here to make your heart health journey easy, whether your cholesterol stems from PCOS or other causes. We dedicate ourselves to providing you with the most simple, straightforward path to get you the care you deserve to stay healthy. 

Get early access now to monthly at-home testing, clinically proven supplements to help reduce cholesterol and a weekly cholesterol health course. Care comes easy with Zizi — lower your cholesterol within six months from the comfort of your own home.


Androgens: Function, Measurement and Related Disorders | Cleveland Clinic 

Polycystic Ovarian Syndrome: How Your Ovaries Can Affect Your Heart | Johns Hopkins Medicine

Polycystic Ovarian Syndrome and Heart Disease Risk | National Lipid Foundation

Dyslipidemia in women with polycystic ovary syndrome | NCBI

Periods, polycystic ovarian syndrome, heart health | Harvard Health

Can PCOS Cause Weight Gain? | Cleveland Clinic

Polycystic ovary syndrome (PCOS) - Symptoms and causes | Mayo Clinic

Polycystic Ovary Syndrome (PCOS) | NICHD

Dyslipidemia in Obesity: Mechanisms and Potential Targets | NCBI  

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