PCOS & Menopause (& Inositol?)

by Amy Medling, founder of PCOS Diva

Polycystic Ovarian Syndrome (PCOS) is a life-long syndrome. PCOS is one of the most common endocrine disorders found in women, affecting approximately 5-10% of women worldwide, with less than 50% of them diagnosed. The syndrome is present throughout a woman’s life from puberty through post-menopause and affects women of all races and ethnic groups. Women with PCOS wrestle with an array of possible symptoms including obesity, irregular menstrual cycles, infertility, depression, acne, hair loss, and more.

PCOS is not cured by menopause. As women with PCOS age, we continue to have high levels of insulin, impaired glucose metabolism, and higher insulin resistance compared to women without PCOS. These conditions can eventually lead to cardiovascular diseases, type 2 diabetes, and metabolic syndrome. Hirsutism or atypical hair growth can remain long after the onset of menopause.

Hormones

Interestingly, as women with PCOS enter peri-menopause, they often see their menstrual cycles begin to regulate. Multiple studies demonstrate a reduction in testosterone and androgen levels in general for peri-menopausal and menopausal women with PCOS. In fact, they come down to levels that are very similar to women that don’t have PCOS. That said, non-PCOS women’s androgen levels are on the rise during this period of time, so now all women are experiencing some of these androgenic symptoms. In women that have PCOS, it seems that the elevated level of male hormone relative to female seems to persist as do our symptoms.

Metabolism

Risk of cardiovascular disease increases during menopause for all women. Whether they are obese or not, women with PCOS are at higher risk for metabolic issues such as impaired glucose tolerance, type two diabetes, having abnormal cholesterol and lipid profiles, etc. Some research indicates that lipid profiles and cardiovascular risks are more related to the aging process than having PCOS. In a recent study, after adjusting for PCOS, doctors found that a variety of conditions like having high insulin levels, bad lipid profiles, and high blood pressure were all more strongly related to obesity rather than having PCOS. Dr. Rashmi Kudesia explains, “if we can just help women that have PCOS avoid those morbidities, avoid gaining too much weight, avoid developing diabetes and really bad heart disease during those reproductive years, by the time they get to the menopause, their risk is really reduced relative to their reproductive years where having PCOS was such a big risk factor.”

What Can We Do to Manage PCOS During Menopause?

The best thing you can do is maintain the healthy lifestyle that helped you manage your symptoms before menopause. Be sure to eat a well-balanced, PCOS-friendly diet of non-inflammatory foods. Continue to make movement a part of your daily routine. Yoga and strength training may be particularly beneficial. Maintain a “PCOS Diva” mindset wherein your self-care is prioritized and you expect to thrive! Finally, keep up your supplements. Revisit your regimen periodically, as your needs may change a bit as you progress through this new stage.

Inositol for PCOS in Menopause?

During the reproductive years, many women with PCOS take inositols to manage blood sugar and hormone levels. As you may know, insulin resistance (IR) triggers increased testosterone. IR and high testosterone are common symptoms in women with PCOS, which cascade into a host of hormone related health issues ranging from difficulty with fertility to acne and hair loss. Studies have shown that women with PCOS who take an inositol supplement each day will reduce their insulin resistance, improve their hormone levels, and have more regular menstrual cycles. In addition, inositol is a lipotropic agent which helps your body remove fats from your organs and blood. While inositol is most commonly thought of for restoring menstrual cycles and fertility, replacing clomiphene or metformin, current research promises a role well beyond these symptoms.

Due to the decreases in insulin and androgen levels when patients take MYO inositol, it is also believed to help reduce hirsutism and acne. Studies also find that subjects receiving MYO saw decreases in testosterone, triglycerides, and blood pressure. In addition, it has been linked to the activation of serotonin receptors which may help lessen appetite, depression, and anxiety while it improves mood.

Two recent studies looked specifically at menopausal women and use of inositols. In the first, they found a remarkable decrease in metabolic syndrome in women who took inositol and determined that Myo-inositol was a good choice for insulin sensitization and treatment of metabolic syndrome. The second study looked specifically at Myo-inositol plus diet and the link to blood pressure. This study found a significant decrease in diastolic blood pressure, HOMA index, and serum triglycerides, and an improvement in high-density lipoprotein cholesterol. This study also recommends supplementation with Myo-inositol.

Amy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness.