Around one in every five women has polycystic ovary syndrome (PCOS), which is a medical condition with wide-ranging symptoms including irregular periods, acne and weight gain. This condition can make it tricky to spot signs of menopause, because symptoms can be very similar to those of menopause. 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, but 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’s common for periods to come less frequently than usual, 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 androgens, ‘male’ hormones, leading to excess facial and body hair growth and acne
- Raised insulin levels and resistance to insulin throughout the body
There isn’t a cure for PCOS, but your symptoms can be managed with lifestyle changes and medical treatments.
You can find more information about PCOS on the NHS website.
Polycystic Ovary Syndrome (PCOS) and the menopause
You might be wondering how PCOS can affect menopause, and vice versa.
PCOS symptoms tend to improve as you age, but some issues are prone to getting worse around the time of menopause. You might notice more facial and body hair than previously, 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. Interestingly though, those without PCOS are thought to ‘catch up’ at menopause, when the two groups begin to have similar risk profiles.
Does PCOS make it harder to identify the 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 to your periods. These can become more or less frequent, and you may also experience a change to your bleeding pattern, including heavier or lighter periods.
Since irregular periods are very common for those with PCOS, with some people going for stretches of months or even years without a bleed, 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 which have been present since your teens or early twenties are more likely to be down 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 lost weight or are maintaining a healthy BMI. 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 flushes or night sweats.
Does PCOS cause hot flushes?
Hot flushes are not a common feature of PCOS. If you notice hot flushes, it’s possible that they are a perimenopause symptom, so check in with your doctor.
Can you take HRT if you have PCOS?
Yes, you can take HRT if you have PCOS. You will get all the usual benefits from the treatment. The non-hormonal healthy lifestyle changes recommended for menopause should also help PCOS symptoms. This is especially true for weight loss if you are overweight.
HRT is the most effective treatment available for menopause symptoms, and works by replacing the hormones no longer produced by your own body. However, HRT isn’t suitable for everyone – read more about HRT risks and benefits.
Speak to your doctor or take Stella’s free online assessment to find out your own personal treatment options.
Does PCOS affect the type of HRT recommended?
If you have PCOS, your doctor will recommend HRT in the same way they would for anyone else. When considering the best HRT regimen for you, they will take into account your general health, any risk factors and your personal preferences.
PCOS itself doesn’t usually mean you will need any specific type of HRT. The lowest-risk form of HRT for everyone is usually a transdermal oestrogen. Find out more about:
Not sure where to start? Learn more about the types of HRT.
When should I see a doctor?
If you think you may have PCOS, check in with your doctor. 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 doctor will be able to advise on the best treatments available 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 to talk to your doctor about. Find out more about menopause on our blog or in our symptoms library.
- 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, Pages 4629–4638,
- Hillard, T. et al (2017). Management of the Menopause. ed. London: British Menopause Society, pp. 143-144
- National Institute for Health and Care Excellence: Polycystic Ovary Syndrome 2018.
- NHS: Polycystic ovary syndrome
- The National Polycystic Ovary Syndrome Association: PCOS diet factsheet
- Royal College of Obstetricians and Gynaecologists leaflet on PCOS
- Verity PCOS UK, website
- 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. doi: 10.1097/GME.0000000000001055
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