Special situations: Polycystic Ovary Syndrome (PCOS)

This is a metabolic disorder characterized by high androgen levels, insulin resistance and infertility that is believed to affect perhaps 6-10% of the female population. The Polycystic Ovarian Syndrome Association has an extensive website with information, referrals, and discussion forums.

For women with the disease who are entering surgical menopause, balancing hormones can present a special challenge. This is a whole special realm in itself, and we can simply caution PCOS women to work closely with their endocrinologists in the balance process. Reading as much as you can about the hormones and their roles is still important, but you need to understand that normal doses and protocols may not be right for you because your body is so accustomed to the abnormal levels you've had for so long. In fact, there seems to be some evidence that even without ovaries, even despite careful HRT balancing, women with PCOS may still use those hormones in atypical ways.

Because most GYN doctors focus on the fertility aspects of PCOS, they may not be your best caregivers once you are in surgical meno. Some women have told us that their doctors have told them that removing their overies has cured their disease—which is in fact not the case, even though it may get rid of one of the more troubling symptoms. Most women with the disorder find that because of the multi-system involvement of PCOS and the fact that having a total hyst does not cure it, their long term needs are better served by an endocrinologist (a hormone specialist) who can treat all aspects of their problems.

For women who seem to always have had an excess of testosterone or seem to have recalcitrant testosterone in surgical menopause, we encourage you to read up on this disorder. It is very underdiagnosed, yet it carries significant health consequences, especially as we age. A proactive approach to surgical menopause survival requires identifying your personal risks, and it may have important impacts on your health for the rest of your life to be aware of this one.