PCOS and Menopause

One in 10 women of childbearing age deal with polycystic ovary syndrome (PCOS). The condition, the exact cause of which is unknown, affects hormone levels, and women with PCOS to produce too much male hormone (androgen).

What happens to women with PCOS, besides things like missed or irregular periods and difficulties with fertility?

A host of symptoms—most commonly acne, weight gain, excessive hair grown (especially where men have hair, like on the face and chin), skin tags or darkening of the skin (in areas like neck creases, groin and underneath breasts), and thinning hair (especially on the scalp, as in male-pattern baldness).

What happens to PCOS as you reach menopause? Does it change?

One thing that does change if you have PCOS is that as you hit your 40s and inch closer to menopause, your menstrual cycles will likely become more regular, says gynecologist and Yale clinical professor Mary Jane Minkin, MD, a member of HealthyWomen's health advisory council. And, she says that typically, women with PCOS hit menopause about two years later than women without PCOS.

So, because women's hormone levels gradually fall during menopause, will menopause "cure" PCOS?

Not exactly, no. Although menopause reduces the hormones progesterone and estrogen, this reduction of hormones does not take care of the effects of having too much testosterone, as women with PCOS do. Although testosterone levels do decrease in women with PCOS, studies have found that this does not occur until about 20 years post-menopause.

Because the PCOS hormonal imbalance doesn't change for many years, there are still the same health risks that have always existed with PCOS, as it affects many systems in the body.

Like what kinds of health risks?

• Diabetes

• High blood pressure

• Unhealthy cholesterol levels

• Sleep apnea

• Depression and anxiety

• Endometrial cancer

• Obesity

• Chronic inflammation

• Stroke

What else do menopausal women with PCOS need to know?

Well, while it's true that aging and perimenopause and menopause do increase the risk of conditions like diabetes, stroke, heart attack and weight gain (we all need to pay attention to these things!), women with PCOS generally have a higher-than-normal risk of these things.

You mentioned higher-than-normal risk.

As in, be extra vigilant. "If you have PCOS, you need to be really prudent," says Dr. Minkin. "Keep an eye on blood pressure and BMI (body mass index); eat a healthy, well-balanced diet; and make sure to get regular exercise." It's especially important to avoid obesity, since it can worsen the disorder. According to the Mayo Clinic, even losing 5 percent of your body weight can make a difference.

What's the latest research on PCOS?

Research is ongoing, but so far, no one has found a cure for PCOS. Rather, its symptoms can be controlled—similar to the way menopause's symptoms can be controlled and managed—with healthy lifestyle changes.

Read more about polycystic ovary syndrome.