There is a conversation about PCOS that most South Asian women have never had.
Not because PCOS is rare in our community. Because it is startlingly common. And because the way it intersects with perimenopause creates a transition that is more complex, more confusing, and more likely to be missed by the very healthcare system that should be catching it.
September is PCOS Awareness Month. And for South Asian women in midlife, it arrives at exactly the right moment.
Why is PCOS so prevalent in South Asian women
Polycystic Ovary Syndrome is the most common hormonal condition affecting women of reproductive age. It affects 1 in 10 women in the UK.
PCOS is particularly common among women of South Asian origin, who have been shown to have more severe symptoms than their Caucasian counterparts. The reasons are complex, a combination of genetic predisposition, higher rates of insulin resistance, and metabolic factors that are already more prevalent in South Asian populations.
Many South Asian women were diagnosed with PCOS in their twenties and thirties, told to lose weight, perhaps given the contraceptive pill to regulate their cycles, and then largely left to manage alone. Some were never diagnosed at all, their symptoms attributed to stress or diet, or their body simply being difficult.
Now those same women are in their forties. And everything is shifting again.
When PCOS meets perimenopause
PCOS and perimenopause are both characterised by hormonal fluctuation; irregular periods, mood changes, weight redistribution, sleep disruption, fatigue, and brain fog. Which means that when they arrive together, distinguishing one from the other becomes genuinely difficult.
Research published in 2026 found that women with PCOS tend to experience a later menopausal transition and may have a lower prevalence of some menopausal symptoms at certain stages. But this does not mean the journey is easier; it means it is longer and more complex, and that the usual markers women and clinicians use to track the perimenopausal transition may not apply in the same way.
For South Asian women with PCOS, the elevated insulin resistance and metabolic risk that come with the condition compound the cardiovascular and metabolic changes that menopause already brings. The risks stack.
And yet the conversation is rarely had.
What to do if this is your story
If you have PCOS and you are in your forties, there are three things worth doing now:
Talk to your GP specifically about the PCOS-perimenopause intersection. This is a nuanced hormonal picture that requires more than a standard menopause consultation. Ask for a referral to a menopause specialist if needed.
Know your metabolic numbers. Blood sugar, cholesterol, and blood pressure matter more, not less, as you move through perimenopause with PCOS. Get them checked regularly.
Trust your symptoms. If something feels different, name it. The overlap between PCOS and perimenopause is real and documented. You are not imagining it.
PCOS Awareness Month is a reminder that the hormonal story does not end at forty. For South Asian women, it often becomes more layered. More complex. More in need of culturally informed, properly supported care.
You deserve that care. Ask for it.
For support and information on PCOS, visit Verity — the UK PCOS charity or the NHS PCOS page.