Yes. I think we should start from zero, because a woman reading the menopause guide may have heard the letters “PCOS” without ever understanding what they actually mean.
there has been a terminology change in 2026, with some experts now using PMOS (polyendocrine metabolic ovarian syndrome) rather than PCOS to emphasize that the condition affects more than the ovaries. Because PCOS remains the overwhelmingly familiar term, I’d use “PCOS (also referred to by some experts as PMOS)
What Is PCOS?
PCOS stands for Polycystic Ovary Syndrome, a common hormonal and metabolic condition that can affect a woman’s reproductive system, metabolism, skin, hair and overall health. Despite its name, you do not have to have ovarian cysts to have PCOS. The condition is primarily associated with hormonal changes, including higher-than-usual levels or effects of androgens—hormones often described as “male hormones,” although women naturally produce them too—and problems with regular ovulation. PCOS can cause periods to become irregular, very heavy, widely spaced or absent, and some women experience acne, excess facial or body hair, thinning hair on the scalp, difficulty becoming pregnant or changes in weight. Many women with PCOS also have insulin resistance, meaning their bodies have difficulty using insulin effectively. This can affect blood sugar and make the body more likely to store fat, particularly around the abdomen. Importantly, PCOS does not look the same in every woman: some women have several symptoms, while others may have only one or two and may go years without knowing that they have the condition. PCOS is not simply a problem with the ovaries and it is not caused by something a woman did wrong. It is a lifelong condition that can change as a woman moves through different stages of life—including perimenopause and menopause—and understanding that history can become especially important as she gets older.
I would put this before the paragraph we just wrote about PCOS and menopause. That way, a woman who has never heard of PCOS isn’t suddenly confronted with terms like androgens, insulin resistance, and ovulation without context.
And I particularly want to keep “you do not have to have ovarian cysts to have PCOS” in there. That’s one of the biggest misconceptions about the condition.
PCOS Doesn’t Necessarily End With Menopause
If you have lived with polycystic ovary syndrome (PCOS), reaching menopause does not necessarily mean that the condition disappears. As ovarian hormone production changes, some of the classic signs of PCOS—particularly irregular periods and problems with ovulation—may become less noticeable simply because menstruation has ended. But the underlying hormonal and metabolic characteristics of PCOS can persist. Research has found that women with PCOS in the peri- and postmenopausal years may continue to have higher androgen levels and lower levels of sex hormone-binding globulin, which can contribute to ongoing facial or body hair growth, acne or scalp hair thinning. PCOS is also associated with insulin resistance, abdominal weight gain and changes in blood sugar and cholesterol metabolism, and these are particularly important to monitor as menopause itself can bring changes in body composition and metabolic health. (OUP Academic) For Black women who have spent years being told that weight gain, unwanted facial hair, hair loss or changes in their skin are simply cosmetic problems, this distinction matters: PCOS is a whole-body condition, not something that ends when your periods do. At the same time, it is important not to assume that every symptom after menopause is caused by PCOS. New or rapidly worsening facial hair, severe acne or other signs of increased androgen activity after menopause should be evaluated by a healthcare professional, because other causes need to be ruled out. (DOI)
“If You Have PCOS, Don’t Assume Menopause Has Cured It
Your Beauty Routine, Your Environment & Your Hormones
For Black women, conversations about hormonal health need to include something that rarely gets discussed: our beauty routines can also be sources of chemical exposure.
Hair relaxers, straighteners, styling products, nail products, fragrances and cosmetics can contain or be associated with exposure to substances such as phthalates, parabens, bisphenols and other endocrine-disrupting chemicals (EDCs)—chemicals capable of interfering with the body’s hormonal signaling.
Research among Black women has found that using hair products is associated with higher levels of several phthalate, phenol and paraben biomarkers in the body, while studies of Black women have also linked frequent or long-term use of chemical hair straighteners with uterine health outcomes, including fibroids and, in some research, uterine cancer.
That does not mean your relaxer caused your PCOS or that you need to throw away every beauty product you own. It means that reducing unnecessary exposure is a reasonable precaution—particularly if you have PCOS or other hormone-sensitive conditions.
You might choose fewer chemical straightening treatments, avoid applying relaxers to an irritated or burned scalp, look for products with simpler ingredient lists, ventilate your space when using strong chemical treatments
We have evidence that nail products can contribute to endocrine-disrupting chemical exposure, and growing evidence connects EDC exposure with PCOS it is important to consider “3-free,” “5-free” or other lower-chemical nail products when available. Nail polish and other personal-care products can also contribute to exposure to phthalates and phenols; research specifically in Black women has found associations between nail-polish use and biomarkers of these chemicals. The goal isn’t perfection. It is exposure reduction.
Your hormones already have enough work to do without making your everyday beauty routine another unnecessary source of chemical exposure.
Feed Your Hormones: What You Eat Matters
There is no magic “PCOS diet,” and food cannot cure PCOS—but what you eat can make a meaningful difference to one of the condition’s major drivers: insulin resistance. Instead of thinking about dieting as starving yourself into submission, think about building meals that help keep blood sugar and insulin more stable. Research supports dietary patterns emphasizing high-fibre foods, lower-glycemic carbohydrates, healthy fats, adequate protein and minimally processed foods, with Mediterranean-style eating showing promising benefits for insulin resistance and metabolic health.
That can look remarkably familiar in an African or Caribbean kitchen: beans, lentils and peas; leafy greens such as mchicha, sukuma wiki and callaloo; okra; avocado; tomatoes and peppers; sweet potatoes; whole grains such as oats, brown rice or less-refined maize; nuts and seeds; eggs; fish such as sardines, mackerel and salmon; and unsweetened yoghurt or other protein-rich foods.
You do not have to abandon your cultural foods—you may simply need to rethink the balance of the plate. Pair carbohydrates with protein, fibre and healthy fat rather than eating a large portion of starch by itself; choose whole fruit more often than juice; and make vegetables a substantial part of your meal.
Omega-3-rich fish, nuts and seeds are particularly interesting because omega-3 intake has been associated with improvements in some metabolic measures in PCOS. And please forget the idea that every woman with PCOS needs an extreme low-carb or ketogenic diet. Current evidence does not identify one perfect diet for PCOS; the most useful approach is one you can sustain while supporting your metabolic health, nutritional needs and enjoyment of food.
🌿 Your PCOS Self-Care Toolkit
1. Protect your sleep.
Poor sleep can make everything feel harder—mood, appetite, energy and metabolic health. Aim for a consistent sleep and wake time, reduce late-night screen exposure, and pay attention to persistent snoring, morning headaches or extreme daytime sleepiness. Sleep disorders, including sleep apnea, are more common in women with PCOS. (Monash University)
2. Move your body—but don’t punish it.
You don’t need to become a gym fanatic. Walking, dancing, swimming, cycling, strength training, yoga or simply being less sedentary all count. The guidelines emphasize that there isn’t one magical exercise programme for PCOS; the best activity is one you can actually sustain. Adults should generally aim for 150–300 minutes of moderate activity a week, alongside muscle-strengthening activity on two days. (ASRM)
3. Build muscle as you enter midlife.
This one is particularly worth emphasizing for women approaching menopause. Resistance training—weights, resistance bands, bodyweight exercises or Pilates-style strength work—helps preserve muscle and supports metabolic health. Think stronger, not simply smaller.
4. Stop making the scale your only health measurement.
PCOS can make weight management frustrating, but health improvements can happen even without weight loss. Waist circumference, blood pressure, blood glucose, cholesterol, fitness, sleep and how you feel are also meaningful measures of health. The international guideline specifically warns against weight stigma. (ASRM)
5. Take your mental health seriously.
This is huge. Women with PCOS have increased rates of depression and anxiety, and the guideline recommends psychological assessment and appropriate support. (ASRM) If you are persistently anxious, depressed, overwhelmed, struggling with body image or losing interest in things you normally enjoy, don’t dismiss it as “just hormones.” Talk to someone.
6. Don’t let PCOS steal your relationship with food.
You don’t need to live on salads, eliminate every carbohydrate or feel guilty after eating something you love. The evidence does not support one particular diet as the PCOS diet. Sustainable healthy eating that fits your culture, budget and preferences is the goal. (ASRM)
7. Schedule the health checks you keep postponing.
PCOS is associated with increased metabolic and cardiovascular risks, so don’t make every doctor’s visit about your reproductive system. Ask about blood pressure, blood sugar/diabetes risk, cholesterol and cardiovascular health, as appropriate for your age and circumstances. (Monash University)
8. Look after your hair and skin without blaming yourself.
Acne, unwanted facial hair and scalp hair thinning can all occur with PCOS. You don’t have to accept them as something you should simply “live with.” Dermatological treatments, prescription treatments and cosmetic options—including laser hair removal in appropriate cases—can be discussed with a qualified professional. (ASRM)
9. Protect your sexual wellbeing.
PCOS can affect body image, libido, sexual function and relationships. And then menopause can introduce another layer of hormonal and vaginal changes. Painful sex, vaginal dryness or loss of desire deserve a conversation with a healthcare professional—not embarrassment or silence. (ASRM)
10. Learn to advocate for yourself.
This might be the most important self-care practice of all. Keep a record of symptoms, medications, menstrual history, sleep changes and major changes in your body. Take questions to appointments. If something doesn’t feel right, ask “What else could this be?” Self-management and shared decision-making are specifically emphasized in the international PCOS guidance. (ASRM)
Self-care is not another job for a woman who already does everything. It is learning to pay attention to yourself before your body has to shout.
