Polycystic Ovary Syndrome and Obesity

 

by Dr. Majida Al-Irhayim

 

There is close association between obesity and polycystic ovary syndrome (PCOS). Women with PCOS are on average more obese than their non-PCOS counterparts.

Women with PCOS commonly misinterpret this relationship, assuming that PCOS leads to obesity. In fact it is more likely that obesity drives polycystic ovaries to be more clinically manifest.

What Determines Obesity?

• Genetics.

• Energy expenditure.

• Energy intake.

• Composition of diet.

Obese women with PCOS, are at risk of developing type II diabetes mellitus, there is increase Insulin resistance, which could be acquired through obesity and also inherited.

In PCOS women, sex hormone binding globulin concentrations (SHBG) are low; this is related to the degree of obesity and Insulin resistance. The lower circulating SHBG concentrations may increase the bioavailability of testosterone (male hormone) and thereby potentiate the androgenic manifestation of the syndrome.

Targeting Obesity in the Management of PCOS

So fundamental is the link between obesity and PCOS, so life style modification is the most important first line management in obese women with PCOS.

Weight loss in women with PCOS has resulted in improvement in the clinical features of the syndrome and in most of the biochemical markers related to it. Weight loss through dieting and exercise adding to it Metformin (glucophage) have been shown to improve fat distribution, insulin sensitivity, luteinizing hormone (LH) hypersecretion, and androgen excess in women with PCOS. These changes reflect clinically, with improvement in oligomenorrhea and anovulation, with moderate benefit to hirsutism.  

The improvement in insulin sensitivity appears to be the prime mover in above changes. For this reason insulin lowering agents and insulin sensitizers have become a major part of the treatment program for obese women with PCOS.

It must be realized that Metformin alone is not sufficient, diet and exercise are important in the prevention of type II diabetes in at risk population.

 

 

	TOP
Contact Details:

	Direct line:	Hospital Tel:		Extension:
Assisted Conception Unit	24597815	24592600
	24583720
Emergency Services (ER):	Tel: 24583600			24-hours