Written on April 19, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Polycystic ovary syndrome, or PCOS, is a common cause of infertility in women and people assigned female at birth.[1-3] The condition impacts 6% to 12% of women of reproductive age in the United States, though PCOS is a lifelong health condition.  It is also a leading cause of fertility issues in this population.
PCOS is a complex disorder, and the exact cause is unknown; however, higher than normal androgen hormone levels have a role. [1,3] Other conditions and factors associated with PCOS are obesity, family history, and insulin resistance. [1,3] Obese women and those with a family member with PCOS or type 2 diabetes are likelier to have PCOS. Though obesity is associated with PCOS, the relationship is complicated and still not very clear. Additionally, insulin resistance related to being overweight, regardless of the cause (unhealthy diet, lack of exercise, or family history), is also a factor in PCOS.  Insulin resistance is when the body’s cells no longer respond well to insulin. [4,5] Insulin's function is to facilitate the transportation of sugar or glucose into the body's cells. Insulin resistance is associated with PCOS and can also lead to type 2 diabetes.
PCOS involves a set of symptoms caused by abnormal hormone levels that affect people assigned female at birth. PCOS signs can vary from obvious to highly vague, and some people may only experience one symptom while others may have multiple. Your healthcare provider may diagnose you with PCOS if you have at least two of these three symptoms [1,4]:
Additional PCOS symptoms include acne, hair growth, darkened skin in body creases, unpredictable periods, oily skin, and weight gain.[1,5]
The initial therapeutic option for PCOS is weight loss through lifestyle modifications. Changes in diet to include healthy, well-balanced meals with increased physical activity are central to helping decrease body weight and can contribute to managing other health issues. Therapy for PCOS also includes hormone modulator medications and laparoscopic ovarian drilling. Treatment takes into consideration PCOS symptoms, along with other health conditions, and whether pregnancy is part of the overall goal for the individual.
Obesity and being overweight is common in PCOS. About 4 in 5 women with PCOS are obese. Weight loss in those who are overweight may help regulate the menstrual cycle; even a small amount of weight loss may be helpful. Losing weight can also improve cholesterol and insulin levels and help control hair growth and acne symptoms. [3,5] Reduced body weight can improve response to ovulatory induction and hormonal treatments in PCOS.
Weight loss surgery is effective for obesity therapy and has positive implications for obesity-related comorbidities.[5-7] If you are obese and other weight loss therapies have proven unsuccessful, then surgery for weight loss may be an option for you. If you are considering therapeutic options to lose weight, consult your healthcare provider for the best approach based on your medical history, comorbid conditions, and health goals.
Weight loss surgery is recommended as part of management for obesity and the presence of various comorbidities as follows[6,7]:
Weight loss surgery, such as bariatric surgery, has been used to help treat PCOS; however, it is not currently recognized as a first-line treatment for PCOS. Additionally, PCOS alone is not considered a main comorbidity for weight loss surgery.[6,7] Since weight loss has implications for improved insulin resistance, androgen levels, and menstrual cycles, weight loss surgery has the potential to be a treatment option for PCOS.[3,6,7] More studies are still needed to establish PCOS as a leading comorbidity for weight loss surgery. [3,6,7]
If you have concerns about your menstrual cycles or are having difficulty getting pregnant, it’s important to speak with your healthcare provider. It is also essential to consult with your clinician if you are considering weight loss surgery to discuss the potential benefits and risks and explore all therapeutic options.
Everlywell provides access to Weight Care+, a telehealth option that allows you to discuss your weight loss goals and condition with a certified clinician from the comfort of your own home. You can partner with a healthcare provider and get support to optimize your care plan.