Polycystic ovary syndrome and menopause: What is the link?

By Lana Burgess

Reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI

Menopause is caused by a gradual fall in a woman's hormone levels, while a hormonal imbalance causes polycystic ovary syndrome. But can the reduction in sex hormones that brings on menopause cure the imbalance that causes polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a condition that leads to cysts growing on a woman's ovaries. It happens when the sex hormones progesterone and estrogen are out of balance.

Menopause is when a woman's periods stop completely, after a gradual reduction in sex hormone levels.

As both PCOS and menopause relate to changes in sex hormones, people may wonder how they are connected or if one cures the other.

This article explores how the two conditions are connected, the key differences, and the treatments available.

Do PCOS and menopause affect each other?

A woman is considered to have gone through menopause when she has not had a period for 12 months. The average age this happens is at 51 years.

Women with PCOS tend to go through menopause an average of 2 years later than women without the condition.

Menopause does not cure PCOS. When women go through menopause, they may still experience symptoms of PCOS, as well as symptoms of menopause.

Role of hormones

The different roles that hormones play in causing menopause and PCOS are explored below.

Hormones in PCOS

The symptoms that women with PCOS experience are the result of an imbalance in sex hormones. However, the cause of this imbalance is not well understood.

Women with PCOS produce a higher level of the male sex hormone testosterone than most women do. They may also have a lower level of the female sex hormone progesterone.

Increased levels of testosterone cause symptoms, which are explored in the section below. The increase also affects the way another hormone called insulin works. Insulin helps to control blood sugar levels.

An increased level of testosterone in women can make their bodies more resistant to insulin. This means that insulin is no longer able to control blood sugar levels effectively, which leads to high blood sugar levels, and an increased risk of diabetes.

Hormones in menopause

Menopause is caused by a gradual reduction in the female sex hormones progesterone and estrogen. The reduction starts years before menopause proper. This period is called perimenopause.

Over time, once the female sex hormone levels are low enough, a woman stops ovulating. This causes her to stop menstruating.

The reduction in hormones that happens in the lead up to menopause does not redress the imbalance of hormones that causes PCOS. As such, menopause does not cure PCOS.

Symptoms

When people talk about symptoms of menopause, they tend to refer to what happens during the lead-up, known as perimenopause.

Menopause itself is simply when a woman stops menstruating. The perimenopause that leads to this, however, has a number of symptoms.

Some symptoms of perimenopause are similar to symptoms of PCOS.

If a woman starts experiencing symptoms of PCOS in her 40s or 50s, when she may also be experiencing perimenopause, it can be hard to tell the two apart.

Similarities

PCOS and menopause share the following symptoms:

• irregular or missed periods
• infertility
• changes in mood
• difficulty sleeping
• thinning hair on the head
• unwanted hair growth on the face or chest
• weight gain

Differences

Some symptoms are unique to PCOS or menopause. Knowing these differences can help separate the conditions.

Symptoms unique to PCOS that do not occur in perimenopause include:

• acne and skin problems
• headaches
• pain in the pelvis

Symptoms that are unique to perimenopause and do not occur in PCOS include:

• changes in sex drive
• hot flashes
• night sweats
• finding sex painful or uncomfortable
• urine leakage
• infections in vagina and urinary tract
• dryness and thinning of tissue in the vagina

When women with PCOS go through perimenopause, they will experience symptoms of both conditions at the same time.

Changes over time

Research has been conducted into how the hormone levels of women with PCOS change, as they get older.

A study examined women with PCOS and compared their hormone levels with women without PCOS, and then re-examined them 21 years later.

It found that over time, testosterone levels in women with PCOS did decrease gradually. However, they did not reduce to normal levels until 20 years after menopause. This is why menopause does not stop PCOS symptoms from occurring.

While it did not stop all PCOS symptoms, the reduction in testosterone levels had a positive effect as women got older, the study found. The researchers discovered that the women tended to experience more regular periods as they aged.

Treatment and self-management

There are several ways that women can help manage the shared symptoms of perimenopause and PCOS. These include the following:

Managing weight

Both the PCOS and perimenopause cause weight gain. This can increase the chance of type 2 diabetes.

Weight can be managed by:

• controlling plate and portion size
• reducing carbohydrate intake
• eating fresh fruit and vegetables
• exercising regularly

Improving sleep

Both PCOS and perimenopause can make it hard to sleep. People can give themselves the best chance of sleeping well by improving their sleep routine.

Changes include:

• going to bed and getting up at regular times
• reducing clutter and electronic screens in the bedroom
• doing something relaxing before bed

Managing unwanted hair

Both PCOS and perimenopause can cause unwanted hair growth, which can be distressing. Waxing, plucking, or using hair removal cream may help.

Speaking to a doctor or beauty therapist for advice on the best way to remove hair is a good idea for those who are worried. In some cases, a doctor may prescribe medication to help.

Hot flashes

One of the main differentiating symptoms of perimenopause that younger women with PCOS may not experience is hot flashes. The following ideas may help manage hot flashes:

• wearing thin fabrics
• wearing layers that can be removed easily
• keeping rooms at a cool temperature
• cutting down on caffeine, alcohol, and spicy foods
• using a fan

Outlook

Research is ongoing, but there is currently no cure for PCOS. It may also continue after menopause, but following the lifestyle changes suggested can help manage symptoms.

Menopause happens to every woman as she gets older. There is not a cure for menopause as it is simply a life change.

Using some of the ideas explored above can help make symptoms more manageable.

SOURCE: MEDICAL NEWS TODAY