PCOS and Menopause - I Thought I Was Too Old for This

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. Experts claim that as many as one in ten women are living with the syndrome. Since the symptoms vary so much, many times PCOS goes undiagnosed for a long time. Essentially, what happens is that a woman's ovaries, and in some cases her adrenal glands, produce more male hormones (androgens) than normal and the production is spurred on by insulin resistance.

How an Excess of Male Hormones Affects Women

When a woman produces a high level of androgens (male hormones) the result can often be devastating. Androgens, including testosterone and other male hormones, can cause hirsutism (excessive body hair growth), acne, and irregular periods. Other symptoms include:

· Infertility - due to irregular periods and lack of ovulation

· Male-pattern balding

· Obesity

· High blood pressure

· Diabetes mellitus

· Cancer

· Acanthosis negricans (darkened, thickened skin around the neck, armpits, or breasts)

· Sleep apnea

PCOS is a systemic syndrome, meaning it affects more than one area of function in the body. It causes increased insulin production which is what signals the ovaries to release extra androgens. Blood sugar issues are typical in women with PCOS. Women with PCOS are at risk for a number of other serious conditions that stem from the syndrome so a complete blood workup and a visit to an endocrinologist is important.

It Doesn't Just Go Away

Some doctors believe that PCOS disappears after menopause; however, the fact is that the symptoms can linger for many years after the cessation of menstruation. Hirsutism, hair loss, and weight gain often continue and diseases like diabetes, cancer and cardiac disease don't just disappear when menopause is over. However, some symptoms do improve for some women after menopause.

How PCOS Affects Post-Menopausal Women

There is not a lot of research available on PCOS in post-menopausal women. It can be difficult to diagnose and to monitor at that stage in life as well, especially since one of the markers is irregular periods. Once a woman goes through menopause, she can no longer use her periods as an indication of problems. Since estrogen levels drop significantly and progesterone levels change, using a measure of testosterone and DHEA-S blood levels to diagnose and monitor PCOS is less informative. However, even though PCOS is difficult to diagnose in post-menopausal women, it should be addressed in order to prevent or mitigate serious complications of insulin resistance that come along with PCOS. These include:

· Cardiovascular disease

· Diabetes

· Abnormal lipid panels

· High blood pressure

· Obesity

PCOS, Insulin Resistance and Weight

Insulin resistance that is prevalent with PCOS causes weight issues for most women dealing with the disorder. With metabolic changes that come naturally with age coupled with hormonal changes, in order to maintain a healthy weight women just have to work a lot harder. A healthy diet and lots of exercise become the order of the day.

Weight loss during menopause is problematic because once the ovaries are finished producing estrogen the body has to rely on fat and the adrenal glands for hormone production. Add insulin resistance to the mix and you have a tough way to go when it comes to weight loss.

In order to keep symptoms under wraps and help promote a healthy life, a woman who is both menopausal and has PCOS needs to follow a strict exercise regimen and eat a diet that is lower in carbohydrates. Lowering carbohydrate input lowers insulin production and insulin is what fires PCOS symptoms. Low carbohydrate diets may also help to keep the weight that results from a slower metabolism after menopause in check. Nutritional support is also advised to help round out the basic nutritional needs a woman who is post-menopausal needs. 


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