Polycystic ovary syndrome (PCOS) is often thought of as a condition that affects younger women, but it can develop or persist well beyond your twenties and thirties. In fact, many women over 35 don’t realise they have PCOS because its symptoms can change with age, overlap with perimenopause, or simply go unnoticed. Here’s what to look out for — and why it matters.
What is PCOS?
PCOS is a common hormonal disorder that affects how the ovaries function. It’s linked to imbalances in reproductive hormones, and while its exact cause isn’t fully understood, genetics, insulin resistance, and inflammation are believed to play a role. Importantly, you don’t need to have ovarian cysts to have PCOS.
PCOS symptoms that may be missed after 35
1. Irregular or infrequent periods
By your mid-30s, cycle changes might be attributed to perimenopause or stress. But if your periods are consistently irregular — either unusually heavy, too light, or spaced far apart — it could be a sign of PCOS.
2. Difficulty managing weight
Many women with PCOS struggle with weight gain, especially around the abdomen. This can occur even if your eating and exercise habits haven’t changed, and it’s often linked to insulin resistance.
3. Thinning hair or hair loss
Rather than excess facial or body hair (a hallmark of PCOS in younger women), those over 35 may notice thinning hair on the scalp — particularly around the crown.
4. Persistent acne or oily skin
Adult acne that’s hard to treat, especially along the jawline, could be a clue. Many women think breakouts are behind them by their mid-30s, so they may not connect this with PCOS.
5. Mood swings and low energy
PCOS can affect mental health, contributing to mood changes, anxiety, and fatigue. These signs are sometimes dismissed as general life stress, but they may warrant a closer look.
6. Fertility struggles
Some women only discover they have PCOS when they encounter challenges conceiving. Ovulation issues linked to PCOS can persist into your late 30s and early 40s.
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Why early diagnosis still matters
Left unmanaged, PCOS increases the risk of long-term health concerns such as type 2 diabetes, high blood pressure, and heart disease. Early detection gives you the chance to take action — whether through lifestyle changes, medication, or a combination of both — to protect your health.
When to see your doctor
If you’ve noticed any of these symptoms, or if something just doesn’t feel right, speak to your GP or gynaecologist. A simple check-up, which might include blood tests and an ultrasound, can provide clarity and help you get the right support.
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