Polycystic ovary syndrome (PCOS) can show different symptoms at different stages of life, meaning teenagers and adults may experience changes in how the condition affects them over time. Therefore, it needs to be considered and managed at every life stage because symptoms and health concerns can shift as you grow older.1
For many women between 18 and 35 years of age, concerns often focus on visible and reproductive symptoms such as excess facial hair, acne, emotional well-being and fertility. During these younger adult years, irregular periods are common symptoms that may signal hormonal imbalance. Some women may also experience excess hair growth on the face, stomach or back. Acne or pimples may occur and can sometimes be severe. Difficulty getting pregnant and emotional health challenges, such as anxiety or depression, can also be part of the experience.1
After the age of 35 years, health priorities often shift from visible symptoms to long-term health risks. Women in this age group may focus more on risks such as diabetes, heart disease and an increased risk of womb cancer.1
As women approach their 40s, many enter perimenopause, a gradual transition towards menopause that can last many years and may be a complex experience for women with PCOS. During this phase, some women may notice temporary changes such as more regular periods, less acne or reduced excess hair growth due to hormonal changes. However, symptoms may also become more challenging, including unpredictable bleeding, mood changes, weight gain, sleep disturbances and hot flashes (sudden, intense sensations of heat).2
In menopause, especially in women with PCOS, testosterone levels and insulin resistance (where cells do not respond well to insulin, a hormone that regulates blood sugar) often remain high. This means fatigue may persist or worsen, facial hair may continue or increase, scalp hair thinning may progress, weight gain, especially around the belly, may accelerate and mood swings and brain fog may worsen.3
References: 1. Ask PCOS. PCOS across the lifespan [Internet]. Available from: https://www.askpcos.org/articles/pcos-across-the-lifespan/. Accessed on: 12 February 2026. 2. MLRB Network. What happens to polycystic ovaries after menopause? [Internet]. Available from: https://mlrb.net/what-happens-to-polycystic-ovaries-after-menopause/. Accessed on: 12 February 2026. 3. Menopause matters. PCOS and menopause: the hormonal link that could be impacting your health [Internet]. Available from: https://menopausematter.org/pcos-and-menopause-the-hormonal-link-that-could-be-impacting-your-health/. Accessed on: 12 February 2026.