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PCOS Post Menopause – What to Expect

Thousands of women come to PCOS Diet Support everyday, looking for answers to their many questions about PCOS. And I know that only a percentage of you are concerned about fertility. There is another group of women that wonder how PCOS will affect them as they age.

So, in this article, I thought we should have a look at what you can expect with regards to PCOS post menopause. To start with, let’s have a look at the changes that happen during menopause in women without PCOS.

Menopause in Women without PCOS

During menopause, there is a fluctuation in various hormone levels that result in the cessation of menses (women stop having their period). Generally, all women experience an increase in insulin resistance, fat around the belly, and increase in cholesterol (1).

So, let’s see how that compares with women with PCOS. As usual, there’s good news and there’s good news and there’s bad news. Let’s have a look at the bad news first, shall we? That way we can end on a positive note.

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Menopause in Women with PCOS

The Bad News

PCOS-post-menopause-foodThe bad news is that a lot of us would have struggled with insulin resistance, higher than average cholesterol, high testosterone levels as part and parcel of our PCOS. All of this can impact on our cardiovascular system over time, resulting in a higher risk of cardiovascular disease as we age (1).

Also, our hirsutism generally persists post menopause (2)

Okay, so that’s the bad news. Let’s have a look at some positives…

The Good News

Weight and Blood Pressure

Well, to start off with, women without PCOS tend to experience increased blood pressure and increased weight. Well, women with PCOS don’t usually experience this increase. We tend to remain the same (1).

Type 2 Diabetes

Right, this one is a bit of a mixed bag. We are 33 times more likely to develop type 2 diabetes than the general population, before menopause. Not so great. BUT, as women go through menopause, their risk of type 2 diabetes increases too. So, 20 years down the line, the incidence of type 2 diabetes is about equal in women with and without PCOS.

Our Testosterone Levels May Drop

This one we need to put in perspective. Our free testosterone levels at the age of 42-47 will probably drop to half of what they were when we were 20-42. That’s good. But, they will still be higher than the women without PCOS (3).

Longer Reproductive Lifespan

PCOS-post-menopause-childSo here is one more piece of good news. We tend to have a longer reproductive lifespan and will probably start menopause later than the average woman (about 2 years later). So, whilst we may struggle to have children, we also have a longer timeframe in which to have them (2).

So to summarize, what we are saying is that the metabolic markers of women without PCOS will probably worsen to the point of the women with PCOS. The difference then becomes, how long we are exposed to the worsening metabolic markers.

And, we will probably reach menopause later and therefore have a longer timeframe in which to start a family.

So now, my next question would be: Is there anything we can do to improve our outcomes post menopause?

Managing PCOS Post Menopause

We know that PCOS is not going to go away as it is fundamentally an endocrine (or hormone) disorder. It’s not going to stop being a problem when we reach menopause.

It is still vitally important that we continue with a healthy PCOS diet that is going to manage that insulin resistance and weight gain (remember that our weight will probably stay the same through menopause so maintaining a healthy weight will help to improve your metabolic markers over the long term).

Also, the recommended supplements of Inositol, Vitamin D and Omega 3 will continue to address insulin resistance, inflammation and testosterone levels.

And finally, keeping fit and exercising regularly will help to lower your risk of heart disease.

I would love to hear from you, especially if you have any experience of PCOS post menopause. Please leave me a comment below!

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Tarryn Poulton

Tarryn Poulton

Tarryn Poulton is a PN1 Certified Nutrition Coach and PCOS expert who has been a leader in the online PCOS space for over 8 years. Tarryn has the support of leading clinicians from around the world who support her scientific approach to understanding and talking about PCOS this includes all medical journals and ongoing research. You can read more about Tarryn and the team here.

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27 Responses

27 Responses

  1. I”m not sure how active this thread still is– but I’m 52 and am afraid to stop taking birth control because it stopped my hirsutism in my 30s and now I’m scared to death that I’m going to go bald and grow a beard. I know, I know– the negative impacts of BC could be worse. But that’s the fear that’s kept me from stopping. My dr said it was ok– but I really should be stopping soon. She said just stop. Whenever I make that decision. And each month, for the last year, I still refill the Rx. I saw what people were saying about spironolactone– I’ll look into that more. I was diagnosed with diabetes 2 years ago– after several years of insulin-resistance. I can’t seem to lose weight– I eat healthy, no junk, practice portion control…. I need to exercise more, and harder (although my body protests loudly!) Regarding menopause– my dr said it wouldn’t happen as long as I was still on BC but I started getting night sweats about 3 years ago. They’ve mostly gone away. I mostly need some encouragement that I won’t go bald and grow a beard.

  2. I’m 53 now and iagnosed at 34 yrs. bad acne during puberty but now my skin is amazing. Weight had been an issue up/down since age 30 when I went from 130 to 230 lbs in a yr. started metformin and it was great for a while, took 2000 mg a day for 10 yrs and that was it, it stopped working. The PCOS is totally manageable with 40 mg of Prozac for depression. I’m about to have a complete hysterectomy in a month, let’s see what that deos for menopause. I didn’t have periods for years then I did painful and frequent, had the ablation in 2011 and stopped periods until 2018 when they started again so going for the complete hysterectomy . I recently changed to vegan eating and fell amazing and losing weight in a healthy way. Off all medication now loving that, only take VD, B13 and Prozac.

  3. I’m 58 postmenopausal and still have many symptoms of PCOS. My testosterone is still extremely high, pre-diabetic, skin tags, tons of facial hair, I still get pain in my ovaries. I didn’t finish menopause till 54. I’m on a great diet and eat only organic cuz I also have hashimotos and no thyroid so I’m real strict with my diet and my thyroiditis are optimal so I know that isn’t what is causing issues. I’m fixing adrenal fatigue but think I may have sjogrens. What am I missing? I do take a high dose of vit d cuz I was at 11 when it was tested, I know I need to take omega 3 but what else am I not doing? Thanks for any advice

  4. I was diagnosed in my 30s, my testosterone levels were so high the laboratory repeated the test because they saw I was a woman. I thought my constant yeast infections where because of my PCOS but a complicating factor for me was Systematic Nickel Allergy Syndrome. I always knew I was allergic to Nickel but I did not know that you could be allergic to Nickel in food. Being on a low Nickel diet changed my life.

  5. I am a 57yr old who has had a partial hysterectomy at the age of 35 (thank goodness) I don’t think I could have faced another period! Painful, by-weekly, heavy (wore largest pad plus most absorbent tampon and still bled through within an hour) don’t know why I wasn’t anemic! Then went into peri-menopause at about the age of 50. All of a sudden I developed breasts (went from a 36A cup to a 36D cup within a year). Put on 30lbs. but always had major weight fluctuation throughout my life. Now I seem to be itchy like crazy, and I’m having major acne breakouts. Seems overnight I’ve developed the inability to process insulin. Is this normal? I feel like I’m going batty. Want to scratch my skin off. HELP!!!

  6. Tarryn, My name is Jocelyn and I have had PCOS symptoms since age 8; I am now 80 y.o.. I have had a degree in Nutrition & Diet Therapy since I’m 21, and that exceptional pre-med background has saved my life through decades of ignorance, and verbal & physical abuse by the medical profession. Over the past 25 years, I have taught doctors ( ob/gyn & endocrinologists) far more than they have taught or treated me.
    (I won’t address here the Hell of 4 pregnancies, horrible deliveries, & breast feeding with high testosterone & high estrogen, estrogen being provided by fat cells, more so than ovaries.)
    At 80 y.o., the symptoms continue, but no where near as acute as before the age of 65. I had never been given any prescriptions that helped at all until I was 50 when I lied myself into a sonogram & was rushed into surgery 2 days later. The concentration of cysts was so great that one ovary had to be removed & the other “cleaned off as best I I could” said the surgeon. Following surgery, I was put on many estrogen/progesterone combinations and methods of delivery for 10 years until finally, at 62 y.o., Prempro worked the best to help balance the excess androgens. The pressure since childhood on the lower abdomen and leg arteries now relieved post surgery, and after 30 years of several radical vein ligations, I was able to stop doubling up pairs of support hose and halve fast-walking 8 miles a day. It was another 10 years before I could taper off high doses of diuretics (since I was 16). Thirty years later, my current Dr allows me to decide the Prempro dosage based on symptoms. At this stage & age, Drs don’t know how to treat me any better than what they have all my life and I feel like I’m the guinea pig always bringing symptoms ahead of the learning curve of the medical profession. I am so aware of the possible cancer & cardio risks of taking estrogen this long, but miss one pill, and boy do I know it. I can turn firbromyalgia on & off like a light switch. Same with dry eye – 2 days no Prempro (estrogen for lubrication of mucous membranes)I I see a white blur. Meanwhile, I still fast walk, still use hair treatments daily to preserve hair on my head, tretonoin for acne, still inspect my face & body daily for hairs in unwanted places, still eat lo Kal/lo carb/no sodium, take supplements, and accept that I am a “short sleeper”. I get no help with the insulin resistance which is as bad if not worse than ever, & still get annual exams for sight, hearing, dental, & general physical, with the PCOS symptoms now being complicated in new ways by normal aging. I have my own extensive blood tests done every year in addition to my Drs’, alternating special tests for hormone, thyroid, A1C, cardio markers, etc. I have copies sent to my Drs, and thankfully, my current Drs discuss these with me respecfully. This has been a long painful ride, the emotional & social aspects even worse than the physical. We need to re name this syndrome to more accurately convey that every body system is effected, and define it with classifications of diagnostic symptoms for each system &/or organ.

  7. I was dx at 19, had only child at 21, completed menopause at 43, am now 54. Had very bad acne during puberty but that’s all. Since going through menopause I am less hairy. My gyno said now that I have been through the change I don’t need to worry about pcos. Do I need a new gyno? Does Metforman help to lose weight? My daughter also has pcos, bad acne at 33, took fertility pills and then shots to get pg. Second child conceived without fertility help. I know she was on Metforman for a while but I think they just gave it to her in preparation to conceiving.

  8. I am 58, stopped having periods at 50. My problems started at 11 when I started menstruating. I had very bad acne and oily skin, irregular periods and started getting excess facial hair at 20. I was able to get pregnant at 27 but unable to have a 2nd child. I stopped trying to get pregnant at 33 in order to treat PCOS by taking the birth control pill. Unfortunately it was not known back them that fertility increased for PCOS women as they aged. I improved my diet and started losing weight in my 40’s and since menopause I have lost another 25 lbs. for a total of 50 lbs since my early 30’s. I have come to realise that sugar and process carbs (bread, pasta etc) are very bad for me and try to avoid as much as possible. I am currently taking spirinolactone for PCOS and have decrease the amount from 100mg to 75mg with no reoccurrence of excess facial hair or male pattern baldness. My blood pressure is on the low side and triglycerides are normal.

    1. This is an update from Sylvie now age 61. I feel great, look good (get compliments that I have beautiful skin which is very strange considering I had such terrible acne, oily skin in my teens). I stopped taking spironolactone 2 1/2 years ago – body hair has increased a tiny bit but nothing like when I was younger. Continue to eat non-process food, mostly simple home made meals, do yoga, go to bed early etc. I wish I had lived a better lifestyle when younger but such information was not known or available to the average person back then.

  9. I am 58, with PCOS and I am still getting periods! I know!!!! Nightmare. Anyway I am busy investigating Inositol to help me through. Not good having regrets but how I wish someone had told what I know now about 30 years ago when I was first diagnosed. Ho Hum. Thank goodness research and knowledge progresses and will help the next generation – we hope x

  10. I am 48 and think I am in peri menopause. I have times when I have bad hotfalashes right after my period. My cycles are still irregular. Some are 2 weeks long, others 10 weeks. How do I know if this is my PCOS or perimemopause?

    1. Have your doctor run blood tests for hormones. Para-menopause can be detected from these tests. Also have a full panel Thyroid test run. Once you know exactly what is going on with your body then you can arm yourself with supplements and diet to ward off a lot of symptoms. Unfortunately, Menopause is a fact of life – I really don’t like the hot flashes. But I think you can find some reprieve with your cycles. Watch out for hormone replacement therapies. They are now linking HRT’s to breast cancer. I literally forced my doctor to take a full thyroid panel test. I told them specifically what I wanted. I’ve been suffering from chronic yeast infections and have many hypothyroidism symptoms (cross over with PCOS symptoms too). I did my research and found that we need to ask for THS (typcial test) to include a T3, T4, Free T3, Free T4, Leptin, and Sexual Hormone Globulin (SHGB). The doctor told me my insurance might not cover it all, but I don’t care. I have also researched how to read the tests as well. If I’m not satisfied with results with this doctor, my GP, then I’m going to see a specialist.

  11. I’m only 35 but was diagnosed with PCOS 5 years ago and had a hysterectomy a year later. I was wondering if my risk of developing menopause is greater than others?

    1. Keeli-
      We don’t “develop” menopause. It as a stage of out life cycle as women we can’t avoid. The timing may change with any chronic hormonal condition like PCOS. Having my partial hysterectomy may have started my menopause earlier but I was fourty and experiencing perimenopause at the time. Check with an endocronologist well versed in PCOS.

  12. Hi. 2years ago I completed a Cert lll in Fitness, in maintaining this qualification l have chosen to study PCOS (5CESs) through Australian Fitness. I chose to study this as l have 2 daughters with this condition, my first daughter (32 yrs ) was diagnosed 5/6years ago & I was concerned that she may not be able to concieve but now she has two beautiful children, a boy 4yrs & a girl 6 & a half months old. At one stage they were involved in the IVF program because she was unable to fall pregnant but eventually it happened naturaly, during this time she found out about & was diagnosed with PCOS. She manages & understands this condition very well & is a pleasure to watch her with her children knowing how difficult it was falling pregnant. My third child who is 20yrs old has recently been diagnosed with PCOS as well. She is just learning what it’s all about, lucky she has her sister to give her insight & support. I enjoyed reading your article, thankyou for posting it. ?

  13. I have suffered with acne because of increased testerone levels. someone recommended an increase in the intake of zinc. Will this help?
    my apologies for not opening some of the mail sent, but I am on the road a lot because of my job and am not able at all time to check my social media.

  14. I was diagnosed in my late 20’s and had a hysterectomy at 53 due to very painful periods. Since then I have suffered from hot flashes, night sweats, frequent uti’s, genital skin problems and dry eyes. I was put on hrts which helped but I weaned myself of them after 4 years. Now the problems are back with a vengeance and would love some dietary assistance that might help. Grateful for any ideas!

  15. I’m in the post menopausal stage at 48, the thing I have found is now for the last 8 years or so I have been getting periods every month, all through my life I would only get one or two a year..I don’t know if this is a common thing to happen, my doctor said it can happen. lol to be honest its annoying as I don’t want to have children now at my age, I’ve had enough of all the pain that comes with it as well. Is this normal? I’m a bit disappointed at the thought that we are a few years later with menopause as well…I was hoping to have it all over and done with soon!! lol

  16. I will be 50 in two months. I was diagnosed with PCOS at 13. I have been menopausal since the age of 42. My experience has not been what is written in this article. I have fought even harder with insulin resistance, my weight and trying not to have diabetes. I find as soon as I deviate from my otherwise healthy diet, I gain right away, my sugar sky rockets and hot flashes return with a vengeance. My hursitism has slowed down ironically, even though I still go to electrolysis every three weeks. Also, due to menopause, I now have a prolapsed bladder which makes working out even harder, thus not helping to control PCOS symptoms. I was hoping things would calm down after menopause, but this has not been my experience.

    1. Thanks so much for sharing your experience, Ginette! Sounds like you’ve had long, hard road with PCOS and it doesn’t seem to be getting any easier!

    2. I am experiencing the same thing. I rarely eat anything sweet or white (breads, pastas, potatoes, etc.) and have to work out like a mad woman just to lose 10 lbs while it is so easy to gain it back. Menopause has given me insomnia and when I do sleep, it’s only 2 or 3 hours at a time due t I’m so frustrated

      1. For those struggling with PCOS symptoms, in addition to fatigue, have your Thyroid check; a full panel including T3, T4, Free T4, Free T3, Sex Hormon Globulin (SHGB) and Leptin. There are over lapping symptoms with PCOS and Hypothyroidism. So if you haven’t had them checked, do so. You might be happy you did. I’m in the process of testing them right now. I’m Pari Menopausal at 47, partial hystorectomy at 30. I’ve been pari-menopausal since 40. Diganosed with with PCOS at 18.

      2. Wow..now that we slightly older women are chatting, this seems to be a theme! I’m 53yo postmenopausal since 47yo, diagnosed age 16. My hirsutism is worse despite Spironolactone and the weight issue is horrible! Scale doesn’t budge even since supplements and new Metformin- bizarrely I’ve GAINED more since starting Metformin!! Despite eating better and a little less! Anyone have this experience with Metformin? Thank you.

        1. HI Paige, I actually gained weight with metformin too. I took it for a few years in my 20’s. Prior to that I had grown up running track and cross-country so I was used to being very active. Once on metformin I was having diarrhea up to 12 times a day and was so weak I couldn’t do any of that running so I mainly sat around and gained weight. I finally ended up in the hospital once due to being dehydrated and finally realized there was no sense in taking this medication.

        2. Hi, I’m 46 and have had PCOS since puberty. I landed on this website, as I was researching Metformin. I’ve been on Metformin for 14 years. It completely reversed all of my PCOS symptoms within a week of being on it. Have either of you tried it? Now, the reason I was researching is that I believe it’s effecting my memory. I’ve been debating going off of it. However, being on this site, and remembering everything I went through, I’m thinking the good night out way the bad. I’m on 1500mg time release, every night. I have remained thin, eat whatever I want, and limited facial hair. I recently went on Spyrolactone which might be helping with that as well, but I think it has been a life saver. Also, I never got my period, but while trying to get pregnant, I was put on Metformin and got my period with 3 weeks and was prego my 1st month.
          Hope this helps!

        3. Spiro did nothing for me either, it made me sick and I had to be taken off it it, but Metformin helped me lose 50 pounds. I already had a healthy diet and didn’t change it but I began losing rapidly and reversed my prediabetes.

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