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Many women with polycystic ovary syndrome (PCOS) aren’t sure what to expect during perimenopause and menopause. Because PCOS and menopause both affect hormone levels, having both can change your menstrual periods and overall health.
In May 2026, major health groups announced a new name to more accurately describe the condition: polyendocrine metabolic ovarian syndrome (PMOS). We will use the new terminology throughout this article.
If you or a loved one has been diagnosed with PMOS, learning more about what to expect during perimenopause can help you feel better informed. In this article, we’ll explain how PMOS affects menopause, what symptoms to expect, and how to treat them.
PMOS is a long-term health condition that affects hormone levels. It usually begins during the reproductive years and lasts through menopause.
Women with PMOS have higher androgen levels than women without PMOS. They may not ovulate regularly, which can make it harder to get pregnant. They are at an increased risk of type 2 diabetes because their bodies don’t respond well to insulin.
The hormonal changes that happen with PMOS cause small sacs of fluid (cysts) to form on the outside of the ovaries. The cysts surround immature eggs, called follicles, and can keep the ovaries from releasing eggs.
PMOS symptoms often start around the time of the first menstrual period. The hormonal changes that happen with PMOS can cause several symptoms, including:
As women living with PMOS approach menopause, their estrogen and progesterone levels begin to fall. Androgen levels, including testosterone, don’t drop suddenly at menopause. Instead, testosterone levels tend to go down slowly with age.
Women with PMOS may still have higher androgen levels after menopause than those without the condition. This is one reason PMOS symptoms and health risks can continue.
Women with PMOS tend to start perimenopause (the menopause transition) about two years later than women without it. They continue to have higher levels of androgens as estrogen and progesterone go down during perimenopause.
During perimenopause, the ovaries make less estrogen and progesterone, so these hormone levels go down. Once you haven’t had a menstrual period for 12 consecutive months, you’ve reached menopause. At this point, you no longer ovulate and can’t get pregnant.
During perimenopause, androgen levels may rise while estrogen and progesterone levels fall.
Perimenopause can last four years longer in women with PMOS than in women without PMOS.
Both menopause and PMOS can cause weight gain and increase the risk of obesity, type 2 diabetes, and heart disease. Women with PMOS are already at a higher risk of hypertension (high blood pressure) and hypercholesterolemia (high cholesterol levels).
Women with PMOS are also more likely than women without PMOS to have visceral obesity — fat stored deep in the abdomen around internal organs — and insulin resistance.
Some research has found that after menopause, women with PMOS have twice the rate of heart disease as those without PMOS. This may raise their risk of heart attack and stroke.
The hormonal changes that happen during perimenopause don’t cure PMOS. Many women continue to have PMOS symptoms while also developing perimenopause symptoms.
Interestingly, many women with PMOS report that their periods become more regular during perimenopause. Researchers aren’t sure why this occurs, as the periods usually become irregular during perimenopause.
Because perimenopause may last an average of four years longer in women with PMOS than in women without PMOS, symptoms may last longer, too.
Common perimenopause symptoms include:
It can take time to find the right healthcare provider to help you manage your PMOS and perimenopause symptoms. Many women see several providers before finding one who listens to their concerns and offers helpful treatment options.
A 2025 review found that many women with PMOS felt blamed for their weight when they sought care for perimenopause. PMOS raises the risk of obesity, which often comes with a cultural stigma.
Try to find a healthcare provider who listens to your concerns and offers judgment-free guidance about lifestyle changes and medication options for PMOS and menopause.
Lifestyle changes to improve both PMOS and perimenopause symptoms include diet, exercise, and daily habits.
Daily habits that may help you feel better include:
Making sure you’re connected with the right health providers is also important.
Hormonal treatment for perimenopause and menopause is often called menopause hormone therapy or hormone replacement therapy (HRT).
Hormone therapy usually involves taking estrogen or estrogen with progestin (a synthetic form of progesterone) to improve perimenopause symptoms. Hormone treatment forms include pills, patches, gels, creams, rings, and implants.
Adding hormone therapy to your PMOS treatment plan may help with menopause symptoms such as hot flashes and vaginal dryness. It can also lower the risk of serious ongoing health conditions like osteoporosis (severe bone loss).
Other treatment options for PMOS and menopause symptoms include:
PMOS doesn’t go away after menopause, but symptoms and health risks can change over time. If you’re in perimenopause or have reached menopause, talk with your healthcare provider about your symptoms, heart health, blood sugar, and treatment options. The right care plan can help you manage symptoms and protect your long-term health.
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