Once referred to as the “medical black hole,” the transition from the childbearing years to menopause largely has been ignored in women with polycystic ovary syndrome (PCOS), a common endocrine disorder.
The majority of studies on PCOS have examined the reproductive and metabolic disturbances of women of reproductive age, yet PCOS is a chronic condition the medical community realizes must be managed throughout a woman’s life.
The effect of Age on Reproductive Hormones
According to new research, it appears that reproductive hormones in women with PCOS differ from women who don’t have PCOS after menopause. In fact, the reproductive life span in women with PCOS has been found to extend beyond that of women without PCOS due to higher adrenal and ovarian androgen levels.
Surprisingly, women with PCOS are more likely to experience regular menstrual cycles as they age because of the natural decline in androgen levels that occurs in response to menopause. For some women who struggle with infertility, they may have a higher likelihood of pregnancy as they get older.
Constant long-term exposure to elevated androgen levels in women with PCOS can have a lasting effect on excessive facial and body hair, hair loss, and even balding that extends past menopause. Although older women with PCOS reported fewer hot flashes and episodes of sweating compared with women without PCOS, they also reported significantly more hirsutism (64% vs. 9%)
The effect of Age on Body Composition
Only a handful of studies have examined how PCOS affects body composition in older women. Schmidt and colleagues measured the height, weight, and waist circumference of women aged 61 to 79 with and without PCOS and found that as women in both groups aged, they lost height and had greater waist-to-hip ratios.
Women with PCOS maintained their weight as they got older, whereas women without the condition gained weight as they aged. The higher waist-to-hip ratios seen when the women with PCOS were premenopausal disappeared after menopause unlike the weight gain shown among the women without PCOS. The women with PCOS also experienced greater increases in BMI due to their loss in height, supporting similar findings of earlier research.8,9
Elevated waist circumference is associated with an increased risk of metabolic syndrome, type 2 diabetes, and Cardio Vascular Disease in women with PCOS. In addition, increased waist circumference and BMI can negatively impact body image, affect self-esteem, and increase the risk of depression in this population.
Metabolic changes with Age
You may be wondering what happens with insulin and cardiovascular parameters as women with PCOS age. It has been established that women with PCOS have higher levels of insulin than women without PCOS, independent of weight. We also know that women with the syndrome have more inflammation as shown by higher C-reactive protein (CRP) levels and have more dyslipidemia (high triglycerides and low HDL the “good” cholesterol). Well, this is where the news is not good: insulin and other metabolic and inflammatory markers persist and worsen after menopause, but mostly if you are overweight.
In a cross-sectional study, Puurunen and colleagues examined pre-menopausal and post-menopausal women with PCOS and compared them to healthy controls. They found that post-menopausal women with PCOS had greater CRP levels, impaired glucose metabolism and insulin resistance than women without PCOS; levels worsened with age. This shows that women with PCOS are at risk for life-long health conditions such as type 2 diabetes, cardiovascular disease and metabolic syndrome.
There is some hopeful news: Evidence from 1345 women with PCOS found that aging increases insulin resistance in obese women but not in lean and overweight women with PCOS. In fact, women in the study who were not overweight or did not gain weight in menopause did not develop type 2 diabetes. Lean women actually improved their insulin levels as they got older. Authors from the study suggested “if women with PCOS do not become obese they may exhibit a better metabolic profile during their reproductive years.”
PCOS does not disappear as women get older. Women with PCOS differ in reproductive hormones past menopause. Hirsutism symptoms such as unwanted hair growth and balding worsen with age. The most important findings are that metabolic parameters worsen in overweight women with PCOS, increasing their risk for life-long health issues beyond menopause. This supports the need for effective weight management treatment with diet and lifestyle along with early detection and treatment of PCOS.
Ayurvedic Treatment for PCOS in Pune:
Here at SMV Ayurveda Research Center which is based in Pune our aim is to provide best treatment to resolve polycystic ovaries conditions with help of specialized Ayurvedic Infertility treatments of Ayurveda. Here Basic research for the treatment of polycystic ovarian disease (PCOS) is carried out since last 12 years by Vaidya Vinesh Nagare who is Gynaecologist.