Key Points
- To evaluate the response of polycystic ovary syndrome (PCOS) manifestations to sustained and marked weight loss achieved through bariatric surgery in women with morbid obesity.
- Conducted a prospective, nonrandomized longitudinal evaluation at an academic hospital in 36 consecutive premenopausal women undergoing bariatric surgery.
- Identified PCOS in 17 participants and evaluated hyperandrogenism, menstrual patterns, and insulin resistance before and at least 6 months after surgery in 12 patients.
- Marked weight loss (41 ± 9 kg at 12 ± 5 months post-surgery) significantly reduced hirsutism scores (9.5 ± 6.8 to 4.9 ± 4.2; P = 0.001) and total testosterone (69 ± 32 to 42 ± 19 ng/dl; P < 0.02).
- Significant reductions occurred in free testosterone (1.6 ± 0.7 to 0.6 ± 0.3 ng/dl; P < 0.005), androstenedione (4.1 ± 1.5 to 3.0 ± 0.9 ng/ml; P < 0.02), DHEAS (2000 ± 1125 to 1353 ± 759 ng/ml; P < 0.005), and HOMA insulin resistance (6.0 ± 3.0 to 1.6 ± 1.0; P < 0.001).
- Regular menstrual cycles and/or ovulation were fully restored in 100% of the evaluated patients.
Structured PICO
Does bariatric surgery improve hyperandrogenism, menstrual function, and insulin resistance in morbidly obese women with PCOS?
PPopulation36 consecutive premenopausal women with morbid obesity undergoing bariatric surgery, including 17 with PCOS (12 evaluated for response)
IInterventionBariatric surgery
OOutcomeHyperandrogenism, menstrual function, and insulin resistance before and at least 6 months after bariatric surgerysurrogate
Bariatric surgery-induced weight loss in morbidly obese women with PCOS significantly improves hyperandrogenism, insulin resistance, and menstrual function.