One thing that is to be noted is that mild hair losses and perhaps a little bit of acne is not unusual. But if a woman experiences major hair growth on her face, hair loss, or major onset of acne, that this could be a totally different problem and that she should be evaluated by a physician for that. This is Doctor Talks.

Hello and welcome. Today we're going to be talking about what is probably the most common hormonal condition in women, polycystic ovary syndrome. It's said to affect at least 10 % of women worldwide. It's characterized typically by irregular cycles and high androgens, which are the things that may cause excess hair growth or acne or possibly male pattern balding. often obesity, and on ultrasound, what is often seen are multiple small cysts on the ovaries. Women with polycystic ovary syndrome have risk of other medical conditions when they're even in their 40s and 50s, such as stroke, high blood pressure, diabetes, and so on. So it seems to be a fairly general…

kind of endocrinopathy or abnormality of the endocrine system. It's not well understood. Women with polycystic ovary syndrome during their reproductive years tend to have difficulty conceiving, although it's not an absolute barrier to conception by any means. In the later years of their reproductive life, these women tend to have more regular cycles and they actually go through menopause a couple of years later than women without this history. There's been some questions about what these women will experience after their last cycle or in their menopause and that's what we're going to be talking about today. There recently was a study published that looked at 28 different research articles, and it's what's called a meta-analysis. And a meta-analysis, I'm going to read this directly, is a research process used to systematically synthesize or merge the findings of single independent studies using statistical methods to calculate an overall or absolute effect. The studies that these researchers analyzed We're looking at women with PCOS who had gone through menopause and the studies were conducted all over the world actually. So this gives it a particular strength that one study which is focused only in one geographic area and often with only one racial or ethnic type, those studies don't have the strength that a study combining multiple sites will have. The increase in numbers gives it more statistical validity. So something that may be observed in one study that may not have statistical power, when it's combined with other studies, the statistical power may be there to draw a more robust conclusion. What these researchers found was that women who had had PCOS in their reproductive years, in their menopausal years, continued to have cholesterol abnormalities, specifically their HDL cholesterol was low and that's called the good cholesterol. Their triglycerides were also higher and both of these are typically associated with increased risk of cardiovascular disease and this is what the researchers did note. They noted that these women were more likely to have high blood pressure, they were more likely to have cardiac events such as a myocardial infarction or a heart attack, they were more likely to have stroke. They continued to have some elevation of their androgen levels. Those are the hormones that can cause abnormal hair growth or acne. And they did tend to have a little bit of an increase in hair issues and acne compared to women who had not experienced PCOS previously. The researchers noted that These women should have increased surveillance for risk factors such as blood pressure, cholesterol, and glucose measurements to rule out diabetes. But of course, all of us, as we go through our menopause, are at risk for cardiovascular disease, high blood pressure, and diabetes.

So this is probably something that most of us would have had in any case. The good news is that these Women tend to not have as many issues with osteoporosis or thinning of the calcium in their bones, since their hormone levels are on average a little bit higher overall than women who were in the control group with normal menses. I'm putting a rather lengthy document in the show notes from a research committee. Women with this history need to be basically super vigilant. But as we've talked about in our videos previously, all women in their menopausal years need to be concerned about cardiovascular conditions and type 2 diabetes and so on. One issue which was not mentioned in the meta-analysis but was brought up in the committee report is sleep apnea. Stopping breathing during our sleep, even though we may not be aware of it.

can cause a number of downstream problems. It seems as though women in their reproductive years do have an increased risk of sleep apnea if they have polycystic ovaries, and this may be linked to their risk of obesity as well. They said that basically the research had not been very well done for sleep issues in older women. Again, we know that many older women do have sleep issues, so this wouldn't be a big surprise. One thing that is to be noted is that mild hair losses and perhaps a little bit of acne is not unusual. But if a woman experiences major hair growth on her face, hair loss, or major onset of acne, that this could be a totally different problem and that she should be evaluated by a physician for that. So the take-home message here is that PCOS women should be a little bit more mindful than the rest of us and also trying to achieve healthy diet and healthy weight because most of these risks were strongly correlated with obesity as they are in women who did not have a history of PCOS. So if you have any comments about your experience as a menopausal woman with a history of PCOS, we would love to see them in the comments below and perhaps share them in a future episode. Otherwise, if this is the kind of information that's useful and interesting to you, I hope you will like and subscribe. And I hope you tune in again. It's been great to have you with me today, and I hope to see you again soon. Thanks. Thank you for tuning into Dr. Talks. We hope today's episode has enlightened and inspired you on your path to optimal health. Each day is a new opportunity to make choices that empower your well-being. For more insights and strategies, subscribe to our podcast. and visit our website, www.doctortalks.com. Stay connected, stay healthy, and join us next time on Doctor Talks, real talks from real doctors on the issues that matter to you most.

PCOS & Menopause

Patricia McShane, MD

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