PCOS and Obesity

Around 15% of women of reproductive age will suffer from polycystic ovarian syndrome (PCOS).

Patients need to have 2 of the 3 important criteria for diagnosis of PCOS. These are:

• irregular menstrual cycles
• high levels of testosterone (associated with excessive hair growth or high blood test levels)
• features on an ultrasound of the ovaries.

This criteria means that women can be diagnosed with PCOS with a normal ultrasound – quite confusing for the condition of ‘polycystic ovarian syndrome’. The term refers to the appearance of small cysts along the outer edge of enlarged ovaries of some women with PCOS.

PCOS is associated with insulin resistance, and this then leads to many other problems. The insulin resistance causes high rates of gestational diabetes as well as Type 2 diabetes. It can also cause higher testosterone production, which can cause excess hair growth and acne.

There is a circular relationship between PCOS and obesity – having PCOS can lead to significant weight gain, and difficulty with your weight due to insulin resistance. Others have PCOS after gaining significant amounts of weight. It is important to note that around 60% of women with PCOS are obese.[1]

If patients are obese with PCOS, there are significant benefits to losing weight. Even a 10% decrease in weight, can lead to a significant improvement in fertility for most women.

Treatment for PCOS can include anti-diabetic medication, as well as stopping smoking, regular exercise, and a healthy diet.

For some patients however, weight-loss surgery is the treatment of choice. The most benefit for patients with polycystic ovarian syndrome and a BMI 35 is a sleeve gastrectomy or gastric bypass. As a bariatric surgeon in Adelaide, Dr Balalis often sees patients with PCOS and obesity who are referred by an obstetrician or fertility specialist after struggling to fall pregnant for some time. Dr Balalis stresses the importance of greater dialogue with patients and their GPs, to provide early intervention and wind back the effects of PCOS.

There are many safe options for the treatment of obesity currently available in Adelaide with Dr Balalis. There are medications available, including Saxenda and Contrave, which are safe and can assist in decreasing hunger. There is also a gastric balloon, the Allurion program, which Dr Balalis performs in South Australia to assist patients in creating new routines. It provides a feeling of fullness sooner and for longer periods.

Dr Balalis performs all types of weight loss surgery, including sleeve gastrectomy, gastric bypass, and revision surgery, which are all very safe and recommended for patients with a BMI 35 and over.

It is always important to consult with a Bariatric or weight loss surgeon prior to consideration of the options available – a tailored approach.

It is always important to consult with your Doctor.

For further information, please contact Dr Balalis.

[1] – Malik et al. Ddefining the role of bariatric surgery in polycystic ovarian syndrome patients. World J Diabetes 2012 Apr 15; 3(4): 71-79.