Guest post by Dr. Felice Gersh
It has long been believed that once menopause was reached, women with PCOS no longer faced a higher risk of adverse metabolic health risks than women of the same menopausal status who did not have PCOS. That never made the slightest bit of sense when one thinks about the underlying health challenges that face women with PCOS throughout their lives. How could all past health issues evaporate to create an equal health risk status?
The simple answer is that that belief was absurd and incorrect. Women living with PCOS face a greater risk of earlier onset of cardiometabolic diseases than non-PCOS women – both before and after reaching a menopausal status. And knowing this important fact will enable physicians to better care for their menopausal PCOS women and empower PCOS gals to take the initiative to optimize their health during the many years they live as postmenopausal women.
To understand the health risks involved with being menopausal, one must understand the significance of menopause on women’s health, regardless of PCOS status.
Menopause is not simply about the end of fertility and periods. Menopause is the end of ovarian function – the ability to produce the life-giving and supporting hormones estrogen and progesterone.
Estrogen, in particular, provides information to cells throughout every organ system to support metabolic health and facilitate the perfect synchronization of all organ systems – thereby optimizing the functioning of the entire body.
In the form of estradiol, the type of estrogen made by ovaries, estrogen should be renamed. The “sex“ hormone label should be changed to “life” hormone. Estrogen coordinates the production, utilization, distribution, and storage of energy in the body and manages all aspects of the immune system. These are the issues essential to life.
We need to recognize that loss of estrogen from the ovaries creates a substantial metabolic shift in every female body, resulting in the evolution of all the harmful diseases and conditions associated with aging – such as diabetes, all manner of cardiovascular disease, increased cancers, osteoporosis, osteoarthritis, dementia, mood issues, and more.
This hormone loss affects every woman as she transitions into menopause and during the many years after that.
Menopause for women with PCOS
Women with PCOS enter menopause with heightened metabolic risks and often already have diagnosed conditions such as prediabetes, diabetes, hypertension, obesity, mood problems, sleep apnea, etc.
Those risks continue and are exacerbated with the loss of ovarian estrogen, and so women with PCOS are more likely to experience accelerated progression of their metabolic problems.
Not well recognized is the fact that the ovaries of young women with PCOS produce less estrogen than the ovaries of other women, and their estrogen receptors have some degree of malfunctioning. Due to these estrogen problems – leading to lower estrogen levels and function and compounded by high androgens, PCOS women live in bodies with higher levels of inflammation. Menopause furthers this state of inflammation, which underlies the chronic diseases of aging.
The Good News
These facts sound depressing and can make a woman approaching menopause feel lost about what to do.
Lifestyle approaches can change the trajectory of one’s health! The happy news is that a great deal can be done.
- Eat regularly timed meals without snacking
- Fast from dinner to breakfast for 13 hours
- Eat a plant-based diet with lots of colorful vegetables and fruits
- Work to get in 7-8 hours of quality sleep
- Exercise regularly
- Get a mind-body practice
- Lower exposures to plastics and toxic substances
These life changes can positively affect your metabolic function.
Bio-Identical Hormones can help
Additionally, the prescription of human bio-identical hormones can be a game-changer. Providing physiologic doses of the critical hormones that nature took from us can dramatically stabilize our metabolic processes and greatly enhance our health.
Women and their health care providers need to recognize that menopause itself creates serious metabolic challenges for all women, as loss of ovarian hormones has impacts body-wide.
And then, they all must acknowledge that women with PCOS have an increased risk of earlier onset of metabolic health problems due to the poorer health of most PCOS women when entering menopause.
By understanding the real and severe effects of menopause, especially for PCOS women, the steps to maintain the best possible health to ensure healthy longevity for decades to come – can and must be taken.
PCOS Diva podcasts with Dr. Gersh:
Other guest blogs by Dr. Gersh:
Dr. Gersh’s Books:
Connect with Dr. Gersh: