Polycystic ovary syndrome (PCOS) is the most common endocrine disorder amongst women of reproductive age. Although PCOS is diagnosed exclusively based on reproductive criteria (clinical/biochemical hyperandrogenism, an/oligo-ovulation, and/or polycystic ovaries (PCO) on ultrasound), it is also a metabolic disorder. Insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, obesity and dyslipidemia are more common in women with PCOS than in age-comparable women without PCOS. Many of the metabolic abnormalities that manifest in PCOS, such as insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, and dyslipidemia are worsened by the concurrent incidence of obesity. However, some of these metabolic perturbations occur even in lean women with PCOS and therefore are rightfully recognized as intrinsic to PCOS. The intrinsic factors that produce these metabolic disturbances are reviewed in this thesis paper. Regarding obesity as both an amplifying factor for other disturbances and as a PCOS-induced disturbance is legitimate, as obesity exacerbates the other PCOS-induced disturbances yet, it is itself an intrinsic PCOS-induced disturbance since it arises more frequently in PCOS women than in control cohorts. The consequences of obesity and the other metabolic aberrations are also discussed. Most importantly, these metabolic perturbations lead to chronic low grade inflammation and to cardiovascular impairments that heighten the risk of having cardiovascular disease. Following a review of cardiovascular impairments and cardiovascular events that have been reported in studies on women with PCOS, this paper then proceeds to discuss therapies currently implemented to minimize these cardiovascular risks. Therapies such as oral contraceptives and anti-androgenic medications used to manage the reproductive manifestations of PCOS may themselves be a cause of metabolic perturbations. Therefore, factors influencing the cardiometabolic side effects arising during the treatment of the non-metabolic manifestations of PCOS (hirsutism/anovulation) will also be discussed in an effort to minimize the overall cardiometabolic risk.