PCOS and Menopause

Living with polycystic ovary syndrome (PCOS) in midlife is about more than irregular periods. As you approach menopause, it’s important to know how PCOS can affect your health in the short and long term. 

What is PCOS?

PCOS is the most common endocrine (hormone-based) disorder in women. It is caused by the body producing higher than normal levels of androgens (hormones including testosterone). While people with PCOS have different experiences, a diagnosis of PCOS is given when someone has at least two of the following signs and symptoms:

• Irregular periods
• Excess facial and body hair, acne and male-pattern baldness
• Polycystic ovaries — ovaries that are larger than normal because of changes in their function

Importantly, PCOS can affect metabolic and cardiovascular health as well as reproductive health. Many — but not all — people with PCOS are more likely to have higher levels of abdominal fat, obesity, and insulin resistance.

Do People With PCOS Go Through Menopause?

Yes, women with PCOS follow the typical menopause stages of perimenopause into postmenopause, the time after periods have stopped for 12 consecutive months. However, research suggests that women with PCOS tend to reach the milestone of menopause about two years later than others.

PCOS also creates challenges for understanding your menopause stage. Someone with regular periods will know that they are in perimenopause when their cycles become increasingly irregular. However, someone with PCOS already has irregular periods. 

Instead of relying on cycle length, symptoms may be a more reliable indicator of menopause stage. Hot flashes, night sweats, decreased sex drive and vaginal dryness are menopause symptoms that are not common in PCOS, and can be used to gauge whether you are in perimenopause. 

Finally, menopause doesn’t “cure” PCOS. While PCOS can only be diagnosed during the reproductive years, the effect of the hormonal imbalance does not go away after you stop having a menstrual cycle.

What Hormones Are Affected by PCOS and Menopause

PCOS and menopause both involve significant hormonal changes that can impact various aspects of health and well-being.

In PCOS, hormonal imbalances primarily involve elevated levels of androgens (hormones such as testosterone), along with disruptions in insulin and luteinizing hormone (LH) levels. These imbalances contribute to symptoms like irregular periods, acne, hirsutism (excessive hair growth), and infertility.

During menopause, the primary hormonal change is a decline in estrogen and progesterone. This leads to symptoms such as hot flashes, vaginal dryness, mood swings, and bone density loss.

Is Menopause Worse With PCOS?

The loss of estrogen around menopause increases metabolic and cardiovascular health risks for all women. However, women with PCOS may have an even greater change in their health risks after menopause due to their pre-existing hormonal imbalance. 

Managing conditions like insulin resistance and high blood pressure becomes crucial after menopause for all women, but especially those with PCOS who already have elevated risk of chronic health conditions. Without preventative steps, these concerns often evolve into heart disease and type 2 diabetes.

Research indicates that the day to day experience of menopause symptoms is not significantly different if someone has PCOS. For example, this study found no difference between the hot flashes of women with and without PCOS.

Ultimately, everyone’s experience of menopause symptoms is unique. Some may have a more challenging time than others, but PCOS does not seem to be a clear factor. 

Managing PCOS and Menopause

The best strategies for managing PCOS already focus on maintaining the healthiest lifestyle possible. Expert advice for navigating menopause with PCOS is ultimately a continuation of this holistic approach to manage symptoms and stay healthy with age.

Lifestyle modifications play a crucial role in managing both PCOS and menopause. These may include:

1. Healthy Diet: Emphasize whole foods, fruits, vegetables, lean proteins, and complex carbohydrates to regulate blood sugar levels, manage weight, reduce menopause symptoms and support overall health.

2. Regular Exercise: Exercise is a critical part of maintaining metabolic, cardiovascular, brain, and bone health. Include both regular cardiovascular and strength training for the most benefits in all of these areas.

3. Stress Management: Chronic stress is a major factor in long term health risks. Regular practice of mindfulness and relaxation techniques can help reduce stress levels, improve sleep, and alleviate symptoms such as anxiety and mood swings.

4. Sleep: Getting enough hours of quality sleep is a key part of your body’s recovery from the day and its ability to stay healthy in the long term. Sleep hygiene strategies like maintaining a regular sleep schedule, creating a comfortable sleep environment, and practicing relaxation techniques before bedtime can make a difference for many people. If night sweats, sleep apnea, or restless legs are keeping you awake, get help from a healthcare provider to make a major difference in your long-term health.

5. Medication and Supplements: Lifestyle changes are not always enough. Depending on your medical history and current concerns, you may benefit from prescription medications and/or supplements. Share your concerns and goals with your healthcare provider to learn if hormone therapy or other types of medications are right for you. 

If you’re facing menopause with a history of PCOS, you’re not alone. Above all, work with a trusted healthcare provider to understand your options and monitor important markers of your health.

Stay informed and get expert guidance in adopting healthy lifestyle habits with Midday. Visit us at Midday.Health.