Francesca Lyon, lead nutritionist at FUTURE WOMAN, gives her take on some worrying new research that links PCOS and cognitive decline in later life.
As a women’s hormone expert specialising in ovulatory disorders, I’m always interested in research that shows the long term impacts of conditions like PCOS.
This recent study caught my attention because it showed that women with PCOS actually performed worse in cognitive tests later in life. A very worrying finding.
But why is this the case? And is there anything we can do about it?
Let’s take a look.
PCOS and cognitive health: what did the research say?
A 2024 study published in the American Academy of Neurology Journal found that women with PCOS showed lower performance in areas like attention, memory, and verbal skills by midlife. This suggests that PCOS may be linked to faster cognitive decline over time.
But what could be driving this link?
Why Might PCOS Cause Faster Cognitive Decline?
The researchers pointed to two possible explanations: metabolic health and inflammation. But I think a third option also needs to be considered: low progesterone.Â
Let’s take a look.
1. Metabolism and Insulin Resistance
One of the possible causes cited in the research was issues with overall metabolism and insulin resistance.
Many women with PCOS have insulin resistance, where the body struggles to manage blood sugar levels. In fact, it’s thought that around 70% of PCOS cases are driven by insulin resistance (although I believe this percentage to be higher as most women I see with PCOS have some form of blood sugar dysregulation).
Insulin resistance has been linked to cognitive decline because it increases inflammation in the brain. This can damage brain cells and impair functions like memory and learning.
While this might sound alarming, there is good news: diet and lifestyle changes can have a huge impact on insulin resistance. This is one area of support we can provide through our testing and personalised plans.
2. Inflammation
Chronic inflammation is another possible cause of this cognitive decline according to the research. This is also a common driver of PCOS. And it can harm brain function too.
Inflammation disrupts the way brain cells communicate and can lead to problems with memory and learning.
Inflammation can come from many sources, such as gut health issues, insulin resistance, and stress. That’s why it’s so important to get a personalised approach to PCOS treatment—each person’s inflammation triggers may be different.
3. Low progesterone
I believe there’s another possible driver of this cognitive decline that wasn’t mentioned in the research – the role of our hormones, particularly progesterone.
Most women with PCOS have low progesterone levels, because they don’t ovulate regularly. This is due to high androgen levels that occur with PCOS (which prevent ovulation from occuring) and it’s exacerbated by contraceptive pill use. The contraceptive pill remains the first line approach for women with PCOS, and it works by shutting off hormone production and therefore ovulation.
If you’re thinking that you only need ovulation and progesterone for pregnancy, think again! Progesterone has many other full body benefits, including that it helps protect brain health, supporting functions like memory and mental clarity. Exposure to adequate progesterone is also associated with improved mental health, balanced weight, bone health and even a longer lifespan.
So I believe a lack of progesterone is likely contributing to cognitive decline in women with PCOS.
Restoring natural, ovulatory cycles for women with PCOS therefore needs to be a priority. And indeed this is our main focus at FUTURE WOMAN. This has the best chance at protecting brain health in the long run.
Taking Action: How to Manage PCOS for Long-Term Health
Hearing about these possible impacts of PCOS can feel overwhelming, especially if you’re already dealing with symptoms like acne, weight gain, and irregular periods. The good news is that there are many ways to address PCOS naturally, restore regular cycles, and protect brain health over time.
At FUTURE WOMAN, we support thousands of women each month in managing their PCOS by identifying the root causes through testing and creating bespoke, personalised plans.
With the right help, it’s possible to balance your hormones and reduce the long term risks linked to PCOS.
What's next?
If you’d like to explore more about how to manage PCOS, visit our PCOS hub.
You can also join our FREE PCOS masterclass and learn my 5 step approach to reversing PCOS symptoms naturally.
