Polycystic Ovary Syndrome (PCOS) affects an estimated 10-20% of women in the United States, maybe even more since a high percentage of women never receive a proper diagnosis. This is partly due to the wide range of how this syndrome presents and also because providers lack knowledge and awareness to identify PCOS. The numbers also vary because researchers and physicians are not entirely of one mind what criteria should be used to diagnosis it. PCOS is considered the most prevalent endocrine disorder in women today. Efforts are also under way to reclassify this condition more appropriately, for example as an androgen excess disorder.

Still new to PCOS?

If you were diagnosed with PCOS, or suspect you may have it, but are still new to the subject, I encourage you to read my earlier article on PCOS explaining the biomedical diagnosis as well as treatment options in more detail.

Since PCOS can bring many health risks along with it, as well as affect your ability to conceive and bear children, it should be taken seriously, and you should receive appropriate care and support. Fortunately, it is now pretty clear that the most helpful strategies can be found in Eastern and Western natural medicine, including acupuncture, botanical therapy and nutrition.

What does PCOS mean for women in midlife?

Let’s say you are in your forties or fifties—an age when most women will gradually approach and eventually enter menopause, the cessation of ovulation and menstrual cycles, thus their ability to conceive naturally—you may be wondering if PCOS will just go away and you won’t have to worry about it any longer.

It is true that our ovaries produce less and less androgen at that age, so your periods may become more regular naturally as a result. This is often a welcome reprieve from the earlier ups and downs of irregular, heavy or absent periods. Unfortunately, though, the underlying imbalances in your hormone regulation, and the effects these hormones may have on your body, do not automatically go away.

So, depending on your specific presentation of imbalances, you may be faced with additional weight gain, especially around the midsection. This is often a result of increased insulin resistance that affects your metabolism and puts you at higher risk for metabolic syndrome and diabetes (T2DM). This risk is higher in women with PCOS and often exists long before menopause.

You should also closely monitor your risk for osteoporosis, which generally increases considerably in women past menopause. Some women with PCOS benefit from the higher androgen levels in their younger years and develop stronger bones. Other women who didn’t have periods for long stretches of time and experienced low estrogen levels may be at higher risk for osteoporosis. In addition, PCOS is often associated with lower vitamin D levels, which can affect your bone density.

If you are a middle-aged women with PCOS, you should also be aware of your higher risk of cardiovascular disease connected to altered cholesterol levels, hypertension and insulin resistance. Everyone, not just women with a higher BMI, needs to be mindful about this and pursue a heart-healthy lifestyle. Because of the effects PCOS can have on your metabolism, you are also at higher risk to develop nonalcoholic fatty liver disease.

Lastly, women with PCOS and their gynecologists are often concerned about endometrial cancer. This may result from hyperplasia if you go for long stretches of time without having a period, and is a reason why your doctor may want to medically induce menstruation every 3-6 months so you can shed the inner lining of your uterus. However, keep in mind that while there appears to be a fourfold increase in endometrial cancer in women with PCOS, we are talking about an increase from 0.03 percent to 0.13 percent. Most cases of endometrial cancer are slow growing and treatable if detected early.

Get an early start

Now you have a good sense of the health concerns women with PCOS face as they approach and enter menopause. Just as earlier in life, it will serve you best to become knowledgeable about your condition and start working with a holistic provider on lifestyle changes and nutrition strategies appropriate for women with PCOS. These steps can allow you to alleviate the manifestations of PCOS, restore hormonal balance to your body, and help reduce the risk of chronic conditions like obesity, diabetes, and heart or liver disease that are more likely to affect you than women without the syndrome. The earlier you start, the better the chances that your health and quality of life will benefit in the long term.

© 2020 Christiane Siebert