"What Happens to PCOS During Perimenopause and Menopause?"

If you were diagnosed with polycystic ovary syndrome (PCOS) in your 20s or 30s, you might remember how your doctor handed you a pamphlet with a cheerful woman doing yoga on the cover. eye roll

But what that pamphlet probably didn’t mention is what happens when you go through perimenopause and menopause. Does PCOS go away? Change?

Here’s the science-backed answer: PCOS doesn’t disappear. It evolves.

“Wait. What’s PCOS?”

PCOS affects around 6-13% of women, yet remains one of the most misunderstood hormonal conditions, with a mind-boggling 70% of women remaining undiagnosed.

As we enter perimenopause, PCOS symptoms blend with normal hormonal changes, and it can become hard to tell what’s PCOS versus normal aging symptoms.

How PCOS Changes As You Age

Here’s an example:

For women without PCOS, androgen levels naturally decline with age as ovulation slows. However, in women with PCOS, androgen levels typically remain higher, even as they go into menopause. This hormonal shift can lead to acne, hair thinning, or even facial hair growth.

And in post-menopause? Some symptoms, such as irregular periods, naturally resolve themselves. But metabolic and cardiovascular risks can actually intensify.

A study in The Journal of Mid-Life Health found that post-menopausal women with PCOS face higher rates of type 2 diabetes, metabolic syndrome, and hypertension compared to women without the condition (Sharma et al., 2021).

Simply put, as we get older, PCOS evolves from a reproductive issue to a whole-body health concern.

How To Take Control

This all sounds concerning, but you can take charge. Here’s what you should focus on:

• Blood Sugar Control: As insulin resistance worsens with age in PCOS, stabilize your blood sugar through working out, plenty of protein, and healthy fats. Research also suggests metformin may be effective, so discuss medication with your doctor.
• Heart Health: Women with PCOS face higher cardiovascular risk after menopause. That makes regular blood pressure monitoring and cholesterol screenings a must.
• Endometrial Health Monitoring: Those with PCOS are 5 times more likely (!) to develop endometrial cancer compared to those without (Johnson et al., 2023). So, regular gynecological exams are extremely important.  

Bottom Line

In some cases, PCOS becomes less visible after menopause. But if you suspect you have undiagnosed PCOS, it’s never too late to seek answers.

While there is no one specific test for PCOS, a doctor will usually make a diagnosis after reviewing your medical history, physical examination, select hormonal blood tests, and possibly a pelvic ultrasound. So while you can’t reverse time, you can protect your health going forward.