Does PCOS make menopause worse? An expert explains

If you've got polycystic ovary syndrome (PCOS), you might breathe a sigh of relief when you hit perimenopause, believing that with the end of your period, the symptoms of PCOS will disappear too.

Sadly, this is not always the case, explains PCOS dietician Jodie Relf, who says that perimenopause can even be worse for women who have PCOS.

Menopause and PCOS

The first 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.

This is something Leila Martyn, founder of MyOva experienced. "PCOS masked my perimenopause symptoms, making it challenging to distinguish between the two," she says.

"Both conditions share several overlapping symptoms, such as irregular periods, mood swings and weight changes. Because of this, it was difficult for me to recognise where perimenopause begins and PCOS ends, especially when I've been managing PCOS for years. The hormonal fluctuations that characterise both conditions can blur the lines between them."

Leila realised she was perimenopausal when she noticed a shift in her symptoms.

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"Although I had been managing PCOS for some time, specific changes felt different, such as a new level of fatigue that wasn't typical for my PCOS experience.

"The irregularity in my periods became more pronounced and unpredictable, which was a departure from my usual PCOS pattern. I also noticed changes in my mood and sleep that were more severe than what I had previously encountered."

Telling the difference

PCOS and hormone expert Hannah Alderson explains that while there can be a symptom crossover between PCOS and menopause they are two completely separate matters.

"One is an endocrine disorder and one is a natural hormonal shift," she explains. "PCOS has a diagnostic criteria that would not overlap with the diagnostic criteria of the menopause. The menopause is a metabolic shift driven by the drop of your sex hormones oestradiol, progesterone and testosterone."

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Menopause with PCOS

There are several ways in which perimenopause and menopause can differ for women with PCOS, Jodie says.

Delayed menopause: Women with PCOS typically enter menopause two to four years later than those without PCOS. This delay can make it more challenging to recognise the onset of menopause, as PCOS symptoms can mask early signs.

Increased health risks: While PCOS does not necessarily worsen the menopausal transition itself, it is associated with a higher risk of developing type 2 diabetes, hypertension and cardiovascular disease. This is due to the prolonged exposure to inflammation, insulin resistance, and abdominal weight gain that often accompany PCOS.

Mental health concerns: Anxiety and depression, prevalent among those with PCOS, may intensify during menopause due to hormonal changes. The compounded impact of emotional and physical symptoms can make the menopausal period particularly challenging for women with PCOS.

Managing PCOS in menopause

As an expert in PCOS, Jodie has a few pieces of advice for managing the condition during perimenopause.

Healthy diet

Protein: Include adequate protein to improve insulin sensitivity.

Fibre and carbohydrates: Eat plenty of fruits, vegetables and whole grains to help prevent dyslipidemia, improve blood glucose levels and reduce inflammation.

Fats: Reduce intake of saturated fats to reduce the risk of dyslipidemia.

Exercise

Weight-bearing exercises: Essential for maintaining bone density as you approach and go through menopause.

Muscle mass: Regular exercise helps preserve muscle mass, which declines during menopause, and improves insulin sensitivity.

Mental health: Exercise also plays a crucial role in mental well-being during this challenging and emotional time.

READ: What midlife women want you to know about exercise

Supplements

Omega 3: Helps minimise inflammation and supports heart health.

Inositol: Beneficial for improving insulin sensitivity, reducing cravings for sugary foods, and managing abdominal weight gain.

SHOP: 10 best menopause supplements with top reviews to have on your radar - plus expert tips

Support networks

Connect with others who are also managing PCOS during menopause. Sharing experiences and receiving support can significantly ease the emotional aspects of this transition.