Polycystic ovary syndrome (PCOS) is the most common female hormone condition in the UK that affects around 1 in 10 women¹. Due to a hormone imbalance, women will often have missed periods, irregular cycles, unwanted hair growth and weight control issues.
Considering its prevalence, there are still many misconceptions about PCOS, especially concerning its links to menopause. Dr Thom Phillips, clinical director at Forth and an at-home blood test provider, debunks some common myths and misconceptions associated with the condition.
PCOS goes away with menopause
One common misconception about PCOS is that it only impacts people who are of reproductive age and disappears with menopause, but unfortunately, this is not true.
PCOS is often associated with women of reproductive age because those who have symptoms are most likely to become aware of them during their late teens and early 20s.
However, PCOS is considered a lifelong condition and needs to be managed even after fertility ends.
Women with PCOS can’t go through menopause naturally
Women with PCOS typically enter menopause two to four years later than those without PCOS².
This delay can make it more challenging to recognise the onset of menopause, as PCOS symptoms can mask early signs, but women with PCOS still go through menopause naturally.
Both PCOS and menopause cause hormonal changes and imbalances, but the processes are different. People with PCOS have higher than average androgen levels (hormones such as testosterone). During perimenopause, all women’s ovaries, regardless of whether they have PCOS or not, start producing fewer hormones, particularly estrogen and progesterone.
PCOS symptoms disappear once menopause begins
One issue you might experience in perimenopause is not noticing it has begun, as the symptoms can be similar to the PCOS symptoms you’ve lived with for many years. Both conditions share several overlapping symptoms, such as irregular periods, mood swings, thinning hair, weight gain and excess hair.
Because of this, it can be difficult to recognise where perimenopause begins, especially if you’ve been managing PCOS for years. Symptoms of perimenopause that are not common in PCOS include:
- Hot flashes
- Night sweats
- Vaginal dryness
- New changes in emotional health, such as memory loss, more erratic mood
PCOS makes menopause worse
While PCOS does not necessarily worsen the menopausal transition itself, it is associated with a higher risk of developing type 2 diabetes, hypertension, obstructive sleep apnoea and cardiovascular disease. This is due to the prolonged exposure to inflammation, insulin resistance, and abdominal weight gain that often accompany PCOS. After menopause, the inflammatory aspect of PCOS persists, and the risk of metabolic disease increases as people get older.
How can you manage PCOS during menopause?
Just like having PCOS in your reproductive years, there is much you can do to improve your health and quality of life if you are experiencing this hormone imbalance during perimenopause or postmenopause:
Diet: Some people with PCOS struggle to produce insulin, whereas others have insulin resistance. Both of these conditions result in high blood sugar levels. A healthy, anti-inflammatory diet can boost hormone production and help regulate blood sugar levels.
Exercise: Exercise has been shown to ease both menopause-related and PCOS symptoms. Ageing people should be aware of their greater risk for bone fractures due to lower oestrogen levels. For this reason, weight-bearing exercises like brisk walking, yoga and pilates are all recommended. Other modalities like cycling and swimming are also great.
Managing sleep: Both PCOS and perimenopause can affect sleep. To improve sleep, you should try going to bed and getting up at regular times, keeping electronic devices outside the bedroom, and keeping the room as quiet and dark as possible and with a comfortable temperature.
Can you take HRT with PCOS?
Dr Nicolette Thomson, Senior OBS & Gynae doctor at Forth, says, “Most people with PCOS can safely take Hormone therapy (HRT). It is an effective treatment for managing the symptoms of [peri-]menopause, as both are caused by a hormonal imbalance.
“HRT replaces the missing hormones that naturally decline during menopause, and as a result, eases symptoms. It is also an effective preventative treatment for longer-term health issues such as cardiovascular disease and osteoporosis. As women go through menopause, the risk of developing these diseases increases due to the drop in oestrogen.”
¹https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189332/
About Forth
Forth was started in 2016 with a simple vision: to help people be healthier by understanding their body’s biochemistry. As a female-led company advocating for women’s health, Forth offers a broad range of tests for hormone health and general well-being in its mission to help close the gender health gap by providing women with deeper scientific insights into their bodies.
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