Polycystic ovary syndrome (PCOS) is a common hormone disorder that affects women during their reproductive years. The exact cause of PCOS is unknown, but it often runs in families. Women with PCOS have higher levels of androgens, or “male” hormones, that may prevent the ovaries from releasing an egg regularly. This can cause cysts to form on the ovaries.
What are the symptoms of polycystic ovaries?
The most common signs and symptoms of polycystic ovaries include:
- Irregular periods or no periods at all
- Infertility or difficulty getting pregnant
- Increased hair growth on the face, chest, stomach, thumbs, or toes
- Thinning hair or hair loss on the scalp
- Acne
- Weight gain or difficulty losing weight
- Darkening of the skin, particularly along neck creases, in the groin, and underneath breasts
- Skin tags, which are small flaps of excess skin in the armpits or neck area
What causes polycystic ovaries?
The exact cause of polycystic ovaries is unknown, but several factors may play a role, including:
- Hormone imbalances. Women with PCOS tend to have higher levels of androgens. Elevated androgens prevent the ovaries from releasing eggs regularly, which can cause cysts to form.
- Insulin resistance. Insulin is a hormone that helps convert food into energy. Women with PCOS often have insulin resistance, meaning their bodies cannot use insulin effectively. This causes insulin levels to become higher than normal.
- Inflammation. Some research suggests that women with PCOS have low-grade inflammation that stimulates polycystic ovaries to produce androgens.
- Genetics. PCOS tends to run in families, so having a close female relative with PCOS increases your risk.
Other factors like obesity, not getting enough physical activity, and stress may also play a role in development of polycystic ovaries.
How are polycystic ovaries diagnosed?
Polycystic ovaries are usually diagnosed with a pelvic exam and ultrasound. The doctor will check for enlarged ovaries with small cysts around the outer edges. Blood tests may also be done to check hormone levels. Diagnosis requires two of the following three criteria:
- Irregular periods or lack of ovulation
- Elevated levels of androgens like testosterone on a blood test
- Polycystic ovaries visible on an ultrasound
Do polycystic ovaries go away with menopause?
Yes, the symptoms of polycystic ovaries usually improve after menopause. This is because production of female hormones like estrogen and progesterone declines at menopause. The ovaries will also no longer produce and release eggs after menopause.
Let’s look at this in more detail:
Changes in hormones
Polycystic ovaries occur when the ovaries produce an excess of androgens like testosterone. This hormonal imbalance prevents regular ovulation. After menopause, the ovaries stop releasing eggs and produce lower levels of estrogen, progesterone, and androgens. This hormone shift reduces the excess androgens that contribute to polycystic ovaries.
Changes in ovulation
Women with polycystic ovaries either don’t ovulate or ovulate irregularly. This causes cysts to accumulate on the ovaries. After menopause, women no longer release eggs from the ovaries during the monthly cycle. With no ovulation occurring, cysts cannot form on the ovaries.
Improvement in symptoms
Many bothersome symptoms of polycystic ovaries are related to excess androgens and lack of ovulation. Common symptoms like acne, facial hair growth, irregular periods, and trouble getting pregnant often improve after menopause when hormones stabilize and ovulation ceases.
However, some symptoms may persist after menopause if they are related to other conditions like obesity, insulin resistance, or inflammation. Weight management and a healthy lifestyle are important even after menopause.
Does PCOS put you at higher risk after menopause?
Having polycystic ovaries earlier in life can increase the risk for certain health problems after menopause, including:
Metabolic syndrome
Metabolic syndrome refers to a cluster of conditions like high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess abdominal fat. Women with PCOS are at greater risk for developing metabolic syndrome both before and after menopause.
Cardiovascular disease
Factors like chronic inflammation, insulin resistance, and metabolic syndrome raise the risk of heart disease and stroke for women with a history of PCOS. Maintaining a healthy weight and managing risk factors can lower cardiovascular risk.
Type 2 diabetes
Up to 10% of women with PCOS eventually develop type 2 diabetes due to insulin resistance. Postmenopausal women with PCOS history should continue to monitor blood sugar and practice diabetes prevention habits.
Mood disorders
Women with PCOS may have higher rates of anxiety and depression. Hormonal fluctuations during perimenopause and menopause can also trigger mood changes. Managing stress and seeking support is important.
Endometrial cancer
Women with PCOS have a higher lifetime risk of endometrial cancer compared to women without PCOS. However, the risk decreases after menopause once ovulation has stopped. Yearly screenings may be recommended after menopause.
Tips for managing PCOS after menopause
Here are some tips for women with a history of PCOS to stay healthy after menopause:
- Maintain a healthy body weight through diet and exercise.
- Ask your doctor about screening for diabetes, high blood pressure, and high cholesterol.
- Consider taking medications like metformin to improve insulin sensitivity.
- Eat a balanced diet low in refined carbs and high in lean protein and fiber.
- Aim for at least 150 minutes per week of moderate exercise like brisk walking.
- Seek support for anxiety, depression, or other mental health concerns.
- Get yearly well-woman exams and recommended cancer screenings.
- Talk to your doctor about symptom management during menopause.
Conclusion
In summary, polycystic ovaries typically improve after menopause due to changes in hormone levels and cessation of ovulation. Symptoms like irregular periods, infertility, and excess hair growth often get better after menopause. However, some health risks may persist in postmenopausal women with a history of PCOS. Maintaining a healthy lifestyle and managing risk factors are important. Working closely with your healthcare provider can help ensure you take steps to reduce risks and enjoy good health after menopause.