PCOS doesn't necessarily get "worse" overall with age, but it changes, shifting from primarily a reproductive issue to a metabolic one, with reproductive symptoms like irregular periods often improving, while risks for conditions like diabetes, heart disease, and high blood pressure increase, especially around menopause, because hormonal imbalances persist. Menopause doesn't cure PCOS; it remains a lifelong condition, and while some metabolic risks might appear similar to non-PCOS women after menopause, women with PCOS face them earlier and potentially more severely.
Recent studies have shown that women who were diagnosed as having PCOS 30 years ago have a completely normal life expectancy. An inspection of more than 700 death certificates from women with PCOS has shown that there is no excess risk of cancer in any organ or of heart disease.
The symptoms of PCOS may include:
For many women, PCOS doesn't feel the same every day. Not every woman with PCOS experiences “flare-ups” in the same way, but many describe them as times when symptoms become more noticeable or harder to manage, like breakouts, heavier hair shedding, mood swings or a particularly irregular cycle.
As noted above, 19.21% of women with PCOS also had a pain diagnosis, encompassing either dysmenorrhea or pelvic and abdominal pain.
A ruptured or burst ovarian cyst typically feels like sudden, sharp pain in your pelvis (typically lower and off to the side).
PCOS is a diagnosis of exclusion and is a multiorgan disease affecting most endocrine organs including ovaries, adrenals, pituitary, fat cells, and endocrine pancreas. The manifestations of PCOS are diverse, and up to 50% patients are normal weight.
If you leave PCOS untreated, the syndrome's symptoms will not only worsen, but you may put yourself at greater risk of developing serious conditions such as heart disease, hypertension, type 2 diabetes, and endometrial cancer. PCOS itself is not life-threatening, but it can lead to life-threatening complications.
Take OTC Medication
Non-steroidal anti-inflammatory drugs (aka NSAIDS) include ibuprofen and aspirin, and are common over the counter medications which can help relieve moderate PCOS pain in the lower abdomen.
Common symptoms of PCOS include: irregular periods or no periods at all. difficulty getting pregnant (because of irregular ovulation or no ovulation) excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks.
Vitamin D appears to improve reproductive and metabolic impairment in PCOS through its impact on insulin resistance.
No, Ozempic isn't FDA approved to treat PCOS. But it can be prescribed off-label for PCOS treatment.
Diet for PCOS: What to Avoid
As with many health conditions, adopting healthier lifestyles can improve the symptoms of PCOS. There is good evidence to support adding in whole plant-based foods, such as those suggested on a Mediterranean diet plan or DASH diet. These diets balance fiber-rich foods, healthy fats and foods rich in antioxidants.
The exact reason why these hormonal changes occur is not known. It's been suggested that the problem may start in the ovary itself, in other glands that produce these hormones, or in the part of the brain that controls their production. The changes may also be caused by the resistance to insulin.
JC: Your symptoms can be vague or mimic symptoms of other conditions, so PCOS can go undiagnosed for a while. There's no single test for it, but a physical exam, ultrasound, and blood tests can help diagnose PCOS.
Final Takeaways
Metformin remains the go-to first-line medication for PCOS with insulin resistance, thanks to decades of research, safety, and accessibility. Ozempic may be preferable for those with significant weight loss goals or if metformin is not tolerated or effective.
Studies have shown drinking tea (hot or iced) may help improve PCOS symptoms. Spearmint tea, for example, has been shown to have anti-androgen effects in PCOS and can reduce testosterone. Green tea has anti-inflammatory properties and may even stimulate metabolism.
Currently, the best antidepressant for PCOS and depression is Contrave, a combination of bupropion (which tackles moods) and naltrexone (which seems to help with weight loss).
Women with PCOS appear to be at increased risk for developing cancer of the endometrium (lining of the uterus) later in life. From your teens through menopause, all women experience a monthly buildup of the endometrial lining in the uterus, as the body prepares itself for the potential of a fertilized egg.
This means you may face significant challenges, including that getting Mounjaro covered by your health insurance for a PCOS diagnosis may be difficult or impossible, and you could face significant out-of-pocket costs without a diagnosis like type 2 diabetes or pre-diabetes (depending on your plan).
Some people with PCOS have very heavy bleeding when they do have a period. Signs of excess androgens such as acne or excessive hair growth. Or a blood test confirming high androgen levels. Enlarged ovaries or polycystic appearance of ovaries on ultrasound.
What are the complications?
Since PCOS is a complex metabolic condition involving many body systems, oophorectomy may not be effective in relieving your PCOS symptoms.
An endocrinologist can offer: