Polycystic ovary syndrome (PCOS) is a condition caused by hormonal imbalance, some symptoms of which are similar to those of perimenopause and menopause, so it helps to know how to untangle these symptoms from those of PCOS.

What exactly is PCOS?

Polycystic ovary syndrome occurs when hormones oestrogen and progesterone get thrown out of balance causing irregular periods and higher levels of ‘male’ hormones (like testosterone) in your body which can lead to fluid-filled sacs growing on the ovaries. It is not entirely understood what causes it but it often runs in families. What we do know is that women with PCOS tend to go through the menopause around two years later than the average age of 51.

How are PCOS symptoms similar to perimenopausal symptoms?

Common symptoms of PCOS include irregular or missed periods; difficulty conceiving; mood swings; broken sleep, unwanted hair sprouting up on the face and/or chest and back or thinning hair on the head. Unhelpfully, however, not all women with PCOS have any symptoms.

What is the difference between PCOS and perimenopausal symptoms?

Symptoms unique to PCOS that are not associated with the menopause include acne and other skin problems and pain in the pelvic area. Perimenopausal symptoms that don’t occur in PCOS include changes to your libido, vaginal dryness, painful sex, urinary incontinence, urinary tract infections like cystitis and hot flushes and night sweats.

Do PCOS symptoms improve with age?

There is no cure for PCOS but it can be managed. Research has shown hormone levels of women with PCOS change as they get older as testosterone levels decrease gradually over time but it can take until 20 years after menopause for them to return to normal levels. This decline in testosterone levels does appear to have some beneficial effects on PCOS symptoms, however, making them less severe.

How to manage PCOS and the menopause

There are a number of ways you can help manage the shared symptoms of PCOS and perimenopause. These include:

Keeping your weight down

Both conditions can lead to weight gain (which can also increase your risk of type 2 diabetes and high cholesterol). Help to keep your weight within healthy levels by exercising regularly, watching your portion sizes (to put this in some sort of context an average portion/meal size in the UK is now three times larger than it was in the 1940s), reducing how much alcohol you drink, avoiding too much processed sugary and/or fatty foods and filling up on vegetables and fruit. Losing weight can help to reduce symptoms.

Trying to get better quality sleep

oth perimenopause and PCOS can stand in the way of a good night’s sleep. To help improve your chances of getting one, sleep experts suggest trying to stick to regular bedtimes and getting up times; taking a relaxing bath before bed (some suggest adding muscle-relaxing Epsom salts or magnesium flakes to the water along with relaxing essential oils like lavender) and or sipping a soporific bedtime drink like chamomile tea or cherry juice (which triggers the sleep-inducing hormone melatonin).

If you have been diagnosed with PCOS there are treatments available to help deal with unwanted hair, erratic periods and fertility issues so do talk about these with your doctor.