PCOS Girls: Turns Out We’ve Been Training for Perimenopause Our Whole Lives

There comes a point in your forties when conversations with your friends start sounding suspiciously like the symptoms list for a condition you’ve been dealing with your entire life.

Someone mentions that her periods have suddenly become completely unpredictable. Someone else is complaining that her hair is falling out. Another has discovered a rogue moustache and is researching the best wax strips. There are conversations about terrible sleep, forgetting words and walking into rooms without the faintest idea why you went there.

And I’m sitting there thinking, I have so many opinions on this.

Not because anyone has asked me. Not because I’m a doctor. And certainly not because I have any formal qualifications. But because I’ve had PCOS for most of my life, so when the conversation turns to periods, facial hair, hair loss, weight, skin, sleep or brain fog, I have approximately 40 years’ worth of unsolicited experience ready to contribute. I may not actually say anything. But internally, I’m writing a thesis.

Because while my friends are beginning to discover some of the joys of hormonal chaos in their forties, I’ve been dealing with versions of it for years. And it has occurred to me that perhaps we PCOS girls have been accidentally training for perimenopause our whole lives.

Not intentionally, obviously. If someone had offered me the choice between decades of hormonal nonsense and literally anything else, I would have happily taken the anything else. But after years of insulin resistance, being spectacularly good at gaining weight and considerably less talented at losing it, hair appearing where it absolutely shouldn’t, hair disappearing from where it definitely should stay, acne whenever I dared to come off the pill, periods that didn’t always understand the concept of a calendar, sleep that could sometimes be described as more of a negotiation than a biological function, and brain fog that occasionally made me wonder where my actual brain had gone, I’ve developed some pretty impressive hormonal survival skills.

And now I’m wondering if they’re finally going to come in handy.

First, we need to talk about the name

Let’s start with the name, because even that has become a little complicated.

PCOS — polycystic ovary syndrome — has historically been the name we’ve used for a condition that is actually much more than an ovarian issue. And as of 2026, the international guideline has introduced Polyendocrine Metabolic Ovarian Syndrome, or PMOS, to better reflect the endocrine and metabolic nature of the condition.

Because having PCOS doesn’t simply mean you have cysts on your ovaries. In fact, you can have PCOS without having polycystic ovaries at all.

My own experience certainly hasn’t been confined to my ovaries. I’ve dealt with insulin resistance, weight that seems to gain itself, unwanted facial hair, hair loss, acne whenever I came off the pill, irregular periods, sleep issues and brain fog. I also had cysts on my ovaries, although thankfully they never caused me any trouble.

For years, none of this felt like a superpower. It felt like an incredibly inconvenient collection of things my body had decided to make my problem. But then I hit my forties, and I started hearing other women talk about some of the things I’d spent years navigating. That’s when I started wondering whether all this unwanted experience might actually be useful.

The surprising overlap between PCOS & perimenopause

Before we get carried away, PCOS and perimenopause are not the same thing. PCOS is a long-term endocrine and metabolic condition, generally beginning during the reproductive years. Perimenopause is the transition towards menopause, when ovarian hormone production becomes increasingly variable and eventually declines.

But the symptoms can overlap in some surprisingly familiar ways.

And that is the bit I find fascinating. Look at that list. The conditions are different. The mechanisms are different. But if you’ve spent years living with PCOS, an awful lot of the perimenopause conversation can sound remarkably familiar. Perimenopause itself can bring changes in periods, sleep, cognition, mood, weight and hair, among many other symptoms.

Which brings me back to my original thought.

Maybe we’ve been training for this.

We’ve already learned that our bodies are complicated

One of the biggest lessons PCOS can teach you is that your body isn’t a simple equation.

For many women with PCOS, insulin resistance and other metabolic factors can be part of the picture. That doesn’t mean weight is completely outside our control, but it does mean the simplistic eat less, exercise more and try harder explanation doesn’t tell the whole story.

Then you reach your forties and your body changes again. Perimenopause can affect body composition and fat distribution, and suddenly women who have never had to think much about their metabolism are wondering why their bodies aren’t responding the way they used to.

PCOS girls may already have something valuable going into this stage of life: we’ve had years to learn that a change on the scale isn’t a character assessment.

We’ve already done the guilt.

We’re not booking another appointment.

We’ve already met the hair

Then there is the hair.

If you’ve had PCOS , you probably know the particular cruelty of hormonal hair changes. The hair on your head is thinning while the hair on your chin appears to be entering its peak growth phase.

It’s almost impressive.

You’ve spent years learning the difference between hair you desperately want to keep and hair you would happily remove with industrial machinery. You know your tweezers, your wax, your threading, your lasers and probably exactly which bathroom lighting makes every follicle look like it has filed planning permission.

And then there is the other side of the equation: losing hair from your scalp while gaining it on your face.

The good news, if there is such a thing, is that PCOS girls have already learned not to treat every rogue hair as a personal crisis. We know hair can be hormonal. We know it isn’t a failure of femininity. We know that sometimes you just grab the tweezers and carry on with your day.

We’ve been here before.

We’ve already had the sleep & brain fog conversation

Sleep is another one.

If you’ve dealt with sleep problems alongside PCOS, you may already know what it feels like to be completely exhausted while your body and brain appear to have entered into a private disagreement about bedtime. Sleep issues are recognised as part of the broader burden associated with PCOS, and sleep disturbance is also common during the menopause transition.

Then there is brain fog.

That wonderful moment when you walk into a room and immediately forget why you’re there. When a perfectly ordinary word disappears from your vocabulary. When you’re halfway through a sentence and suddenly have absolutely no idea where you were going with it.

Brain fog is common during the menopause transition, and cognitive and psychological symptoms can also occur alongside PCOS.

So when perimenopause starts talking about poor sleep and forgetting words, some of us can quietly think, I’ve met these two before.

Where do I sign?

Perhaps our real advantage is that we’ve learned to listen

This, I think, is the part that matters most.

Living with PCOS can make you incredibly aware of your own body. You learn to notice changes in your cycle, skin, hair, weight, sleep and energy. You learn that seemingly unrelated symptoms can sometimes be connected. You learn to ask questions.

Is this normal? Is this hormonal? Could these things be connected? Should I get this checked?

And many women with PCOS have also had to learn to advocate for themselves. Diagnosis can be delayed, symptoms can be misunderstood and the condition has historically been under-recognised. The new PCOS name (PMOS) itself is intended to better communicate the broader nature of the condition and improve recognition and care.

That experience is valuable.

Because when perimenopause arrives, the challenge isn’t simply experiencing symptoms. It’s understanding that your body is changing, recognising what is new for you and knowing when something deserves proper medical attention rather than being dismissed as “just getting older.”

PCOS girls have had years of hormonal detective work.

We may not have all the answers.

But we’re pretty good at spotting clues.

This doesn’t mean we’ve got perimenopause figured out

I think this distinction is important because I don’t want to turn PCOS into some kind of hormonal loyalty programme.

There is no Perimenopause Platinum card waiting for us after years of suffering. There is no complimentary glass of champagne, no priority boarding and, disappointingly, no lifetime supply of good tweezers.

Having PCOS doesn’t mean perimenopause will be easier. You may experience symptoms you’ve never had before. You may find the combination of your existing hormonal issues and the menopausal transition particularly challenging.

And because PCOS and perimenopause have different underlying causes, new or significant symptoms shouldn’t simply be written off as one or the other.

But that’s not really the point of this article.

The point is that we’ve already learned how to live in a body that doesn’t always follow the rulebook.

And that is a skill.

Maybe PCOS wasn’t our superpower. Maybe it was our training.

For most of my life, I wouldn’t have described PCOS – now PMOS – as a gift. It has been frustrating, inconvenient and, at times, exhausting. I’ve had to deal with symptoms that other women didn’t have to think about until much later in life.

But sitting here in my forties and listening to conversations about perimenopause, I’m starting to see those years differently.

I’ve learned that hormones can affect far more than your period. I’ve learned that weight isn’t always simple. I’ve learned that hair can change in deeply unhelpful directions. I’ve learned that sleep can disappear just when you need it most, and that your brain can occasionally lose a perfectly ordinary word while you’re still halfway through the sentence.

I’ve learned to pay attention. I’ve learned to ask questions. I’ve learned not to automatically blame myself. And I’ve learned that just because my body is doing something unexpected doesn’t mean it is broken.

That feels pretty useful right now.

So, to my fellow PCOS girls heading into our forties: I don’t know what your perimenopause is going to look like. None of us does. But I do know that you’ve already spent years learning how to navigate a body that doesn’t always follow the standard script.

You’ve already met the hormonal plot twists. You’ve already dealt with the questionable periods, the facial hair, the hair loss, the acne, the weight battles, the bad nights and the brain fog. You may have spent years wishing you didn’t have to know so much about all of it.

But perhaps now we can look at that experience a little differently.

Maybe PCOS wasn’t our superpower.

Maybe it was our training.

And now, as perimenopause walks through the door carrying its own suitcase of hormonal chaos, we might be just a little more prepared than we realise.

We’ve got the experience. We’ve got the questions. We’ve got the hormonal detective skills.

And, frankly, we’ve got the bloody T-shirt.

PCOS girls: turns out we’ve been training for perimenopause our whole lives.

Maybe it wasn’t a superpower at the time.

But perhaps now, finally, it is.