What People With PCOS Need to Know About Menopause

Polycystic ovarian syndrome, or PCOS, is a chronic condition that affects a person’s reproductive hormones. In the United States, it is the most common endocrine disorder in reproductive-aged people with uteruses. People with PCOS typically have elevated levels of androgens, or male sex hormones. As a result, they experience symptoms like irregular periods, painful ovarian cysts, weight gain, and difficulty conceiving. In fact, many patients discover they have PCOS when they seek treatment for infertility.

According to the World Health Organization, PCOS affects anywhere from 8 to 13 percent of reproductive-aged women globally. Since it is a lifelong condition, those estimates include many women in their late 30s, 40s, and even 50s. 

Although much has been said about the diagnostic delays associated with PCOS, there’s often a lack of information about what it’s like to enter perimenopause or menopause while living with this condition. It’s no surprise given the historical lack of funding for medical research on related topics like menstrual pain, and the cultural taboos that still surround menopause.

Many women are under the impression that menopause will “cure” their PCOS. That’s not totally accurate, explains gynecologist Dr. Ruth O. Arumala. “‘Cure’ is a strong word in medicine,” she tells Flow. During menopause, “a person’s PCOS symptoms may resolve, which is the language we like to use. But that’s really not a cure because the underlying issues are still there and may actually be exacerbated.” 

One study from 2021 found that postmenopausal PCOS patients still have clear hormonal and metabolic markers of the condition.

This popular misconception illustrates a need for further education on PCOS and menopause. In honor of PCOS Awareness Month, Flow spoke with multiple reproductive health experts to better understand what people with PCOS can expect as they age. Here are their observations and advice for patients in this demographic.

PCOS patients might not realize they’re in perimenopause.

Menopause marks the end of regular menstrual cycles. It’s a natural biological process preceded by a transitional phase called perimenopause, during which a person’s periods become sporadic or irregular. This is usually when people begin experiencing disruptive physical and emotional symptoms, like hot flashes, vaginal dryness, or mood changes.

People who menstruate regularly won’t have a problem discerning if they’re in perimenopause. But if you have PCOS and don’t get your period every month, “you might not know that you’re not having a period because you’re going into menopause,” says Dr. Arumala. “And if they don’t have periods, they might not know that the symptoms that they’re having — such as night sweats, hot flashes, brain fogginess, lack of concentration, or weight gain — are due to perimenopause or menopause.” 

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