Hormones impact many facets of women’s bodies beyond menstruation. The delicate balance of the endocrine system means that if anything is slightly off, the effects can disrupt our lives in profound ways. Case in point: Polycystic Ovary Syndrome (PCOS) and menopause.
While not directly connected, both PCOS and menopause are related to our hormones and come with a variety of unpleasant symptoms on their own (and conjunctively). However, if properly treated, these conditions can be managed with negative impact minimized.
Read on to learn more about whether menopause can affect PCOS and what you can do to support your body during this time.
What Is PCOS?
PCOS is an endocrine disorder that affects around five to six million reproductive-aged women in the United States. PCOS occurs when the ovaries produce an abnormal amount of androgens, a group of male sex hormones, and is often characterized by missed or irregular periods, cysts on the ovaries, excess body hair growth (hirsutism), weight gain, acne, insulin resistance, and infertility, among other symptoms.
“Genetics, insulin resistance, and hormonal imbalances all play a part in the development of PCOS,” says Dr. Tyler Lloyd, OB-GYN. “Your genetic predisposition is responsible for determining your individual baseline risk. The body often will form a resistance to insulin which results in abnormally high blood sugar levels. The body makes more and more insulin in an attempt to bring these blood sugar levels down, unfortunately causing hormone production and ovarian function to become increasingly dysregulated.”
What Is Menopause?
Often occurring between the ages of 45 and 55, menopause is when a woman’s body starts producing less estrogen and progesterone and her menstrual cycles stop. Menopause is officially diagnosed when a woman has gone at least 12 months without her last period.
The time leading up to menopause when women often experience unpleasant symptoms – like hot flashes, night sweats, mood changes, thinning hair, and sleep problems – is called perimenopause.
How Does Menopause Affect PCOS?
PCOS and menopause are both related to changes in the levels of hormones in a woman’s body.
“Menopause brings with it its own set of hormonal changes. These changes luckily counterbalance many of the hormone abnormalities associated with PCOS. Acne, excessive hair growth, ovarian cysts, and irregular periods often improve or resolve entirely,” says Dr. Lloyd.
The Role of Hormones
Both PCOS and menopause cause hormonal imbalances that disrupt the menstrual cycle. With PCOS, the following hormones play a role:
- Androgens (like testosterone and androstenedione)
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
Women with PCOS often have higher than optimal levels of testosterone, LH, estrogen, and insulin, and lower levels of FSH and progesterone, resulting in an imbalance that leads to the unpleasant symptoms.
The higher levels of male hormones, like testosterone, are what can cause insulin resistance in those with PCOS. This resistance increases blood sugar levels, which in turn increase male hormones, leading to worsening symptoms.
“Hormone dysregulation is the cause of nearly all symptoms of PCOS. Increased androgen levels lead to unwanted hair growth and erratic periods. Increased insulin prompts the ovaries to make more hormones which leads to ovarian cysts and even more androgens which feed back into the hormone cycle to intensify symptoms,” says Dr. Lloyd.
With menopause, women experience a drop in both estrogen and progesterone levels that results in the body eventually stopping ovulation. In the last two years of perimenopause, estrogen declines at a faster rate, leading to many of the symptoms felt during perimenopause.
While PCOS and menopause both affect the levels of hormones in a woman’s body, they do so in different ways, meaning that menopause will not cure PCOS.
Does Menopause Cure PCOS?
Unfortunately, menopause does not cure PCOS and the condition can still cause problems even after a woman has stopped menstruating. In fact, PCOS can cause menstrual irregularities two years after menopause.
“Reproductive hormones and the lipid profile in women with PCOS differ from those in women without PCOS after menopause. Women with PCOS reach menopause a few years later and have lower serum FSH compared with age-matched controls,” according to a 2021 review of research on PCOS and how it affects women over 40.
However, some PCOS symptoms will be less noticeable after menopause due to the change in hormones.
“PCOS is a lifelong condition, however, many of the symptoms often improve or resolve after menopause,” says Dr. Lloyd.
While PCOS symptoms initially start out by primarily affecting the reproductive system, as a woman ages the condition can evolve to a more metabolic disorder with an increased risk of certain diseases.
“Along with various metabolic disturbances like insulin resistance and abnormalities of energy expenditure, PCOS is recognized as a major risk factor for the development of type 2 diabetes and cardiovascular disease (CVD) in later life,” the same review found.
How Menopause Affects Symptoms of PCOS
During perimenopause, women with PCOS may experience slightly different symptoms than those without.
During the menopausal transition, PCOS can actually minimize some symptoms. As a woman with PCOS gets closer to menopause, it’s possible she’ll have more regular periods than she did previously. However, the hormonal imbalance from PCOS will not go away if not addressed, regardless of whether menopause has taken place.
In the same 2021 review of women over 40 with PCOS, women reported fewer hot flashes and sweating than those without PCOS. It’s possible this is due to the increased androgen levels, which may offset some of the more common menopausal symptoms.
However, other symptoms relating to PCOS can get worse during perimenopause and beyond. As women age, it’s normal to experience an increase in insulin resistance and belly fat, as well as lipid imbalance. This means that the metabolic abnormalities in women with PCOS can also worsen with age. Studies show that their waist circumference, cholesterol, and triglyceride levels increase as they reach 40 to 50 years.
“Menopause can often be a turning point for women with PCOS. As hormone fluctuations settle during menopause, PCOS symptoms like irregular periods and ovarian cysts tend to improve. Issues of PCOS related insulin resistance are often unchanged by menopause and require ongoing management throughout one's lifespan,” says Dr. Lloyd.
- Irregular or missed periods
- Difficulty becoming pregnant
- Mood changes
- Difficulty sleeping
- Thinning hair on the head
- Excess hair growth on the face or body
- Weight gain
Can You Get PCOS Later in Life?
PCOS is typically only diagnosed during reproductive years, when the symptoms can be identified as relating to the condition.
“Although a majority of women with PCOS notice symptoms in late adolescence and early adulthood, some individuals won't develop PCOS until their 30-40s and even beyond,” says Lloyd.
According to the previously mentioned 2021 review, “it is not possible to diagnose a woman with PCOS when she has already reached menopause, because the cardinal features disappear.”
Supporting PCOS After Menopause
Since PCOS can persist after menopause, it’s important to remain tenacious in treating the symptoms. This can be done with daily lifestyle changes, including a healthy diet, exercise, and supplemental support.
Maintaining a healthy weight for your body can be hugely beneficial in supporting PCOS symptoms. This can be done by regular exercise and enjoying a healthy, balanced diet.
“Research shows that people with PCOS show evidence of all-over inflammation, which is associated with heart disease and other illnesses. The Mediterranean diet eliminates saturated fats, processed meats and refined sugar, which makes it a powerful tool to address inflammation,” says Amanda Stathos, a clinical dietitian at Johns Hopkins’ Sibley Memorial Hospital.
Insulin resistance can be supported through diet as well.
“Low Glycemic Index (GI) carbs like whole grains and legumes, lean proteins like fish and tofu, healthy fats like avocado and seeds all aid with digestion and blood sugar control,” says Dr. Lloyd.
Regular physical activity is necessary for helping reduce some of the major PCOS symptoms, particularly insulin resistance, which can lead to weight gain and an increased risk of diabetes.
The following types of exercise can be especially helpful for those with PCOS:
- Walking: This easy fitness activity can lower stress hormones and boost endorphins, which can suppress testosterone production.
- Cardio: Cardiovascular activities, such as running, swimming, cycling, or anything else that elevates your heart rate is beneficial for PCOS. This can help with weight gain, as well as anxiety and depressive symptoms.
- HIIT (High-Intensity Interval Training): HIIT workouts, which consist of short bursts of intense exercise followed by rest periods of around one minute, help burn fat and reduce insulin resistance. The positive benefits of HIIT continue even after the workout is finished, thanks to the oxygen debt to your muscles which helps your body continue to burn fat.
- Strength Training: Weight lifting and other muscle-strengthening activities help reduce insulin resistance and decrease androgen levels.
Yoga: One study on women with PCOS showed that those who practiced yoga for one hour three times a week saw “significant drops in their levels of free testosterone and DHEA as well as improvements in their levels of anxiety, sadness, and menstrual cycle management.”
In addition to exercise, PCOS symptoms can be supported through various supplements as well. These include inositols, DIM, folic acid, curcumin, and coenzyme Q10.
Supplements can also be an excellent tool for helping reduce the unpleasant symptoms felt during perimenopause, such as night sweats, hot flashes, hormonal weight gain, and mood issues. These include black cohosh, DHEA, Vitamin D3, and ashwagandha. MENO Menopause Relief offers several of these ingredients in one supplement, for a more comfortable transition into menopause.