PCOS is a common endocrine disorder in young women. It can cause infertility. Most women with PCOS are obese. The gastric band, gastric bypass and sleeve gastrectomy are powerful tools for weight loss. Can weight loss surgery help in the treatment of PCOS and infertility?
What is PCOS?
PCOS is Polycystic Ovary Syndrome. It affects about 10% of women of reproductive age. The ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs. The ovaries release eggs irregularly or even not at all (called anovulation). Menstrual periods can become very irregular or absent. Women with PCOS can have difficulty to get pregnant (infertility). Also, high levels of the male hormones (called androgens) are produced. These can cause excessive facial and body hair (called hirsuitism), thinning or loss of hair from the head, oily skin and acne.
What causes PCOS?
There is no single cause for PCOS. It is believed to be caused by a combination of environmental, genetic and other factors. Obesity may play a role in causing PCOS.
What is the connection between PCOS and Obesity?
About 60% of women with PCOS are obese. There seems to be a vicious cycle of PCOS and obesity. Both cause and increase the severity of the other.
What are the risks of PCOS?
Women with PCOS are at increased risk to develop type 2 diabetes, high blood pressure and high cholesterol levels. Also, PCOS can lead to endometrial hyperplasia (excessive proliferation of cells in the endometrial lining of the uterus), which carries risk of progression to cancer.
What is the treatment of PCOS?
There is no cure for PCOS, but the symptoms can be treated. The UK’s National Institute of Health & Care Excellence (NICE) recommends that women with PCOS and BMI more than 30 should be advised to lose weight. NICE explains that weight loss alone may restore ovulation (release of eggs from the ovaries) and improve the response to ovulation inducing drugs.
What is weight loss surgery?
Weight loss surgery, also called bariatric surgery, can be life changing for obese women in many ways. The operations are the gastric band, gastric bypass and sleeve gastrectomy.
Does weight loss surgery improve PCOS?
There are many studies of the effect of weight loss surgery on PCOS. A meta-analysis has shown that weight loss surgery reduces various symptoms of PCOS.(1) A recent study is based on data from the UK’s National Bariatric Surgery Registry.(2) PCOS is present in 16% of women between ages of 18 and 45 years having weight loss surgery. After weight loss surgery, the symptoms of PCOS were not seen in 15% of women. Also, menstrual periods became normal in 33% of women. The bottom line is that weight loss surgery is not a cure for PCOS but it can help to treat the symptoms of PCOS.
For a consultation on weight loss surgery with Mr Sarela, consultant bariatric surgeon in Leeds, call 0113 388 2127
References
- Charalampakis V, Tahrani AA, Helmy A, Gupta JK, Singhal R. Polycystic Ovary Syndrome and Endometrial Hyperplasia: An Overview of the Role of Bariatric Surgery in Female Fertility. European Journal of Obstetrics Gynecology & Reproductive Biology. 2016;207:220-6.
- Edison E, Whyte M, van Vlymen J, Jones S, Gatenby P, de Lusignan S, et al. Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions that Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR). Obesity Surgery. 2016;26(12):2837-42.