Polycystic ovary syndrome (PCOS) is a medical condition with wide-ranging symptoms including irregular periods, excessive hair growth, acne, and weight gain. Depending on the definitions used, 5-20% of women between the ages of 15 and 45 in the US have this condition. Having PCOS can make it tricky to spot signs of menopause because symptoms can be very similar. Read on for our guide to PCOS and menopause.
What is PCOS?
PCOS is the most common hormonal disorder in women of childbearing age. Despite its name, it doesn’t just affect how the ovaries work. It can cause irregular periods, acne, weight gain, and excess hair growth.
If you have PCOS, you may have struggled with fertility because you might not release eggs every month. It is common for periods to come less frequently, sometimes with several months between each bleed.
The exact cause of PCOS isn’t known, but it is associated with a number of hormonal changes in your body. These include:
- Raised levels of androgens – ‘male’ hormones – that may lead to excess facial and body hair growth and acne
- Raised insulin levels and resistance to insulin throughout the body, which may lead to problems with diabetes and cardiovascular disease
There isn’t a cure for PCOS, but your symptoms can be managed with lifestyle changes and medical treatments.
The link between PCOS and menopause
PCOS symptoms tend to improve as you age, but some issues can get worse around the time of menopause. You might notice more facial and body hair, plus you’re more likely to experience high blood pressure around this time if you have PCOS.
PCOS is related to a higher risk of type 2 diabetes and higher cardiovascular risk through your reproductive years, and these risks continue during and after menopause.
Does PCOS make it harder to identify menopause?
PCOS can make it more difficult to figure out if you are going through menopause. One telltale sign that you are entering perimenopause is a change in your periods. They may become more or less frequent, and you may also experience a change in your bleeding pattern, including heavier or lighter periods. Since irregular periods are very common for those with PCOS, it can make it difficult to track any changes in your cycle.
Other symptoms of PCOS can also be common signs of menopause, such as weight gain, acne, loss of scalp hair, and excess hair on the body and face. One way to differentiate between the two could be to think about how long the symptoms have lasted. Symptoms that have been present since your teens or early twenties are more likely to be due to PCOS.
But you also need to bear in mind that PCOS symptoms can fluctuate over the years, and tend to be much better during times when you have been maintaining a healthy weight. There’s a lot to consider!
New symptoms that start after age 45 are more likely to be due to menopause. This is particularly true if they kick in alongside hot flashes or night sweats.
Does PCOS cause hot flashes?
Hot flashes are not a common feature of PCOS. If you notice hot flashes, they may be a perimenopause symptom, so check in with your healthcare provider.
Can you take HT if you have PCOS?
Yes, you can take HT if you have PCOS. You will get all the usual benefits from the treatment. Healthy lifestyle changes recommended for menopause should also help PCOS symptoms. This is especially true for weight loss if you are overweight.
HT is the most effective treatment available for menopause symptoms, and works by supplying your body with the hormones it no longer produces. However, HT isn’t suitable for everyone – read more about HT risks and benefits.
Speak to your healthcare provider to find out your personal treatment options.
Does PCOS affect the type of HT recommended?
If you have PCOS, your healthcare provider will recommend HT in the same way they would for anyone else. When considering the best HT regimen for you, they will take into account your general health, any risk factors like high blood pressure, and your personal preferences.
PCOS itself doesn’t usually mean you will need any specific type of HT. The lowest-risk form of HT for everyone is usually a transdermal estrogen, such as a patch or spray.
Not sure where to start? Learn more about the types of HT.
When should you see your healthcare provider?
See your healthcare provider if you think you may have PCOS. They will be able to give you a formal diagnosis and advise you on staying healthy and managing your symptoms.
Likewise, if you’re struggling with menopause symptoms, your healthcare provider will advise the best treatments for you.
Seek an urgent medical review if you have:
- Unusually heavy bleeding
- Abdominal pain or swelling
- Changes to your bowel habits
- New, changing or worrying symptoms
Read more about which symptoms you should speak to your healthcare provider about.
- Corrine K. Welt, Enrico Carmina, Lifecycle of Polycystic Ovary Syndrome (PCOS): From In Utero to Menopause, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 12, 1 December 2013, pp. 4629–4638
- Yin O, Zacur HA, Flaws JA, Christianson MS. Association between polycystic ovary syndrome and hot flash presentation during the midlife period. Menopause. 2018 Jun;25(6):691-696
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