Managing the metabolic effects produced by PCOS at different ages

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that can have significant metabolic effects, such as insulin resistance, weight gain, and an increased risk of type 2 diabetes and cardiovascular disease. These effects can vary at different stages of life, requiring tailored management strategies to address changing needs.

What are the metabolic effects of PCOS?

PCOS can lead to a range of metabolic issues, including:

• Insulin resistance: The body becomes less effective at using insulin, leading to higher blood sugar levels.
• Weight gain: Many individuals with PCOS experience difficulty managing their weight due to hormonal imbalances.
• Dyslipidaemia: PCOS can cause unfavourable cholesterol levels, increasing cardiovascular risk.
• Inflammation: Chronic low-grade inflammation is often associated with PCOS, contributing to metabolic complications.

How do metabolic effects vary by age?

The impact of PCOS on metabolism can change throughout a person’s life.

• Teenage years: During adolescence, PCOS often manifests as irregular periods and weight gain. Insulin resistance may also develop, leading to a higher risk of prediabetes. Early intervention can help prevent long-term complications.
• Reproductive years: Metabolic symptoms, such as weight gain and insulin resistance, can persist into adulthood. Women may also face challenges with fertility and pregnancy, including an increased risk of gestational diabetes.
• Perimenopause and menopause: As hormone levels naturally decline, metabolic risks like type 2 diabetes and cardiovascular disease may become more pronounced in older women with a history of PCOS.

How is PCOS managed at different ages?

The management of PCOS and its metabolic effects should be personalised based on age and individual health needs.

• Teenagers and young adults:
  • Focus on lifestyle changes, including regular exercise and a balanced diet, to manage weight and improve insulin sensitivity.
  • Hormonal birth control is often prescribed to regulate periods and reduce symptoms such as acne and excess hair growth.
  • Metformin may be used in some cases to improve insulin resistance.
• Reproductive age:
  • Continue with lifestyle interventions to reduce the risk of diabetes and heart disease.
  • For those planning pregnancy, ovulation induction therapies may be needed alongside metabolic management.
  • Regular monitoring of blood sugar, cholesterol, and blood pressure is crucial.
• Older adults:
  • Address long-term risks, such as type 2 diabetes and cardiovascular disease, through medications and lifestyle changes.
  • A heart-healthy diet and regular physical activity remain key.
  • Monitor and manage bone health, as women with PCOS may be at risk of reduced bone density.

The metabolic effects of PCOS can change over time, requiring age-specific management strategies to reduce long-term health risks. Early intervention and consistent monitoring are essential to minimise complications and maintain overall health. If you have PCOS, consult a healthcare professional to develop a personalised plan tailored to your needs at every stage of life.