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PCOS Treatment Doesn’t Have to Be Dramatic

The treatment few women with polycystic ovary syndrome (PCOS) have considered to improve their chances of pregnancy is significant weight loss. Overall lifestyle changes that focus on fitness, exercise and wellness have been shown to make positive effects on PCOS, even with small amounts of body composition changes that decreases body fat % with or without weight loss.

Exercise is important, any exercise that you do for at least 150 minutes a week is important. HITT workouts may be the best. The effectiveness of high intensity intermittent training on metabolic, reproductive and mental health in women with polycystic ovary syndrome: study protocol for the iHIT- randomised controlled trial – PMC (nih.gov)

Ketogenic diets have emerged as being able to control the abnormal hormone levels better than other types of diets in women with PCOS.

For those who need to lose more, one dramatic solution to significant weight loss is bariatric surgery. And a new study finds that in very obese PCOS patients there are both high rates of pregnancy, and lower pregnancy problems. as well as, more live births. Unchanged were the time to conception, and incidence of prematurity between PCOS patients who did, or who did not have the surgery.

For the study, researchers examined data on 49 women with PCOS and 120 women without the condition who underwent bariatric surgery between 2005 and 2016 were followed through 2019. We will watch this data as the new GLP-1 medications are studied in this group because their data shows in non-PCOS women to have weight loss outcomes that approach the success stories of those with bariatric surgery.

Among women in the study who tried to conceive, pregnancy rates were similar for the group with and without PCOS (95.2% and 76.9%, respectively, p=0.096) and so were live birth rates (81% and 69.2%, respectively, p=0.403).

Dr. Richard Legro, not a researcher on the new study, but who is chair of obstetrics and gynecology at Penn State College of Medicine and Penn State Health in Hershey, Pennsylvania, cautions women, in spite of the positives of this study, “The pregnancy is still high risk.”

Women after bariatric surgery, even with their PCOS, free testosterone levels “normalized” following weight loss, the authors note in Journal of Clinical Endocrinology & Metabolism.

For women trying to conceive, there was still a struggle to conceive, taking most of the women with PCOS almost 3 years to get pregnant.

The newer weight loss medications such as semaglutide is rivaling the weight loss seen with bariatric surgery, so women should consider this alternative.

It is most important to have a pregnancy planning visit, we would love to have a talk by our telehealth portal at Women’s Health Practice if you are planning to conceive and have questions.

SOURCE: https://bit.ly/3kuNLdh Journal of Clinical Endocrinology & Metabolism, online July 7, 2020.


Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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