A new study on women’s health changes what we thought we knew.

A study published in JAMA Cardiology analyzed more than 50 risk factors in 28,000 women followed for over twenty years. The results surprised many physicians: the factor that most increases cardiovascular risk in younger women is not cholesterol. It is diabetes and insulin resistance.

At first glance, this may seem like a finding related to cardiology. But in reality, it says something much broader and more specific about women’s hormonal, gynecological, and reproductive health. All three are interconnected—as they always should be understood. And it also highlights how much progress is still needed to build a healthcare model truly designed around women’s bodies.

The study that changed priorities

Researchers from Brigham and Women’s Hospital in Boston and the Mayo Clinic conducted one of the largest prospective studies ever carried out on women’s cardiovascular health: the Women’s Health Study. More than 28,000 women were followed for a median period of 21 years.

The goal was to understand which risk factors were truly relevant to heart disease in women—and whether meaningful differences existed between younger and older women.

The results, published in JAMA Cardiology, clarified something conventional medicine had been slow to recognize: in women under 55, LDL cholesterol—the marker most physicians monitor first—increases cardiovascular risk by 40%. Diabetes increases it tenfold.

This is not a minor detail. It represents a complete recalibration of priorities.

The silent enemy: Insulin resistance

At the center of this study is not only diagnosed diabetes. Researchers also focused on what they call LPIR (lipoprotein insulin resistance), a marker that measures insulin resistance through six combined lipoprotein parameters.

In younger women, this indicator proved to be six times more predictive than LDL cholesterol for the risk of early coronary disease.

Insulin resistance is a condition in which the body’s cells respond insufficiently to insulin. The pancreas compensates by producing more and more. Over time, this metabolic imbalance affects the entire body: the heart, hormonal balance, the menstrual cycle, and chronic inflammation.

“In otherwise healthy women, insulin resistance, type 2 diabetes, and metabolic syndrome were the primary drivers of early coronary events,” said Dr. Samia Mora, corresponding author of the study and Associate Professor at Harvard Medical School.

A signal the body sends on multiple fronts

What makes this study particularly relevant to women’s gynecological health is that insulin resistance is not just a metabolic issue. It is a broad hormonal disruptor.

When insulin levels remain chronically elevated, the entire endocrine system is affected. The ovaries produce more androgens, altering the menstrual cycle. Systemic inflammation increases, worsening conditions such as endometriosis. The balance between estrogen and progesterone shifts, with effects felt throughout every stage of a woman’s life—from puberty to menopause.

PMOS — Polyendocrine Ovarian Metabolic Syndrome (until a few weeks ago known as PCOS, polycystic ovary syndrome) — is one of the most studied examples: it is the most common gynecological condition among women of reproductive age, and insulin resistance is one of its central mechanisms.

It is no coincidence that the international scientific community has recently officially changed the name of this syndrome. The term “polycystic ovary” was misleading because it reduced a complex endocrine-metabolic condition to an ultrasound image. The new name finally reflects reality more accurately: PMOS involves hormones, metabolism, the cardiovascular system, and reproductive health all at once.

But the metabolic impact on female hormonal balance extends far beyond PCOS.

It affects cycle quality, mood, weight, energy levels, thyroid health, and inflammatory responses.

The metabolic body and the gynecological body are not separate compartments. They are part of the same system.

The bigger problem: Medicine is still behind when it comes to women

The Women’s Health Study is especially valuable because it is rare. Rare in methodology—more than 28,000 women followed over 21 years—and rare in intention: understanding women’s health as its own reality, not simply as a variation of men’s health.

For decades, medical research built its reference models almost exclusively on male populations. Normal values, diagnostic protocols, and risk criteria were all developed around bodies that were not women’s. When findings were extended to women, this was often done by analogy rather than evidence.

The consequences are still visible today: delayed diagnoses, treatments designed for a different physiology, and difficulty obtaining clear answers for conditions that affect women in specific ways—from PMOS (formerly PCOS) and endometriosis to menstrual disorders and hormonal imbalances during perimenopause.

Every study conducted specifically on women is another brick in a structure being built slowly, with too many delays but growing awareness. That is why every piece of research matters. That is why it is worth reading, discussing, and demanding that it become part of clinical practice.

What should we do with this information?

This study is not an invitation to alarm. It is an invitation to awareness.

If you are trying to better understand your body—whether you are dealing with irregular cycles, hormonal imbalance, a gynecological condition, a fertility journey, or simply want a more complete picture of your health—it may be worth asking yourself:

Has my doctor ever evaluated my insulin resistance?

Have I ever had a complete glucose and hormone profile?

Is there something I feel in my body that still has not found an explanation?

This is not about adding new concerns. It is about gaining a more complete understanding.

Because medicine that truly works is medicine that looks at the whole picture—not only at the values we are used to measuring.

The female body deserves medicine designed for it

A study involving 28,000 women observed over two decades confirmed something some researchers have argued for years: the female body is not simply a smaller version of the male body. It has its own vulnerabilities, biomarkers, and specific physiological balances. And it deserves medicine designed accordingly.

Insulin resistance is not just a number on a blood test. It is a signal the body sends—about the heart, hormones, the menstrual cycle, and overall well-being.

Learning how to interpret it is one of the most important challenges for modern medicine if it truly wants to care for women at every stage of life.

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At Mater Clinic, we focus on women’s gynecological, hormonal, and reproductive health—from menstrual care and hormonal balance to fertility support and guidance through different stages of a woman’s life.

We listen to each patient as a whole person and assess metabolic, hormonal, and gynecological factors together because we know none of these exists in isolation.

If you would like to better understand your health and are not sure where to start, we offer a free fertility guidance consultation—available both online and in person, with no obligation.

For our gynecology patients, the first appointment is a specialist consultation: the best way to begin a serious and personalized care journey.

Write to us on WhatsApp at +34 645 096 548—we will be happy to support you.