PCOS does not disappear at midlife. It evolves.

If you have PCOS, the transition to perimenopause brings unique challenges. Specialist management protects your long-term health.

Symptoms you may be experiencing

PCOS manifests differently in every woman, and symptoms can shift as you enter midlife.

Irregular or absent periods

Unpredictable cycles or amenorrhoea

Weight gain

Particularly around the abdomen, resistant to diet and exercise

Acne or skin changes

Hormonal acne, oily skin, or skin tags

Excess hair growth

Unwanted facial or body hair (hirsutism)

Hair thinning

Thinning hair on the scalp, particularly at the crown

Fatigue

Low energy levels and difficulty recovering from exertion

Mood changes

Anxiety, low mood, or emotional volatility

Difficulty conceiving

Fertility challenges related to ovulation

Understanding PCOS in midlife

Polycystic Ovary Syndrome affects up to 1 in 10 women and does not resolve with age. In midlife, PCOS interacts with declining oestrogen to create a complex hormonal picture that requires specialist understanding.

Women with PCOS have higher lifetime risks of type 2 diabetes, cardiovascular disease, and endometrial problems. These risks increase in perimenopause and beyond, making proactive management essential.

A metabolic health approach addresses not just the hormonal symptoms but the underlying insulin resistance and cardiovascular risk factors that accompany PCOS.

Our treatment approach

  • Comprehensive metabolic assessment including insulin, glucose, and lipid profiles
  • Hormonal evaluation in the context of both PCOS and perimenopause
  • Individualised HRT planning that accounts for PCOS-specific considerations
  • Insulin sensitisation strategies — lifestyle and pharmacological where appropriate
  • Cardiovascular risk assessment and management
  • Long-term monitoring of metabolic markers and hormonal balance

When to seek specialist help

If you have a PCOS diagnosis (or suspect undiagnosed PCOS) and are approaching or experiencing perimenopause, specialist management can prevent complications and significantly improve your quality of life.

Specialist PCOS care for midlife and beyond

Dr Sadia Meyer provides comprehensive metabolic and hormonal assessment tailored to women with PCOS entering perimenopause.