Polycystic ovarian syndrome: Managing and treating weight problems
Weight issues are common in women with polycystic ovarian syndrome. These treatments can help.
Polycystic ovarian (or ovary) syndrome is a common hormonal disorder, affecting 5 to 10 percent of women. Symptoms vary from person to person, but usually include irregular periods, problems with sudden weight gain, excess hair growth, acne and difficulty achieving pregnancy. The ovaries may look like they contain several small cysts, or follicles, on ultrasound. This disorder affects both adolescents and adult women.
PCOS weight-loss tips
Women with polycystic ovarian syndrome are more likely to be overweight or obese partially due to increased testosterone produced by the ovaries, and the inability for insulin to function normally in some women. Being overweight increases the risk of developing insulin resistance and Type II diabetes. Women who are overweight or obese are also at a higher risk of developing sleep apnea, high blood pressure, high cholesterol and heart disease. Women with PCOS should be tested for Type II diabetes and high cholesterol.
Weight loss has been shown to reduce the risk of diabetes and disorders related to obesity. In one study, weight loss was shown to work just as well, if not better, than medication alone in reducing the risk of diabetes. Weight loss can lower the amount of male hormones in the body, and reduce abnormal hair growth. Additionally, weight loss can help regulate the menstrual cycle, and improve pregnancy rates. A weight loss of only 2 to 5 percent of body weight can result in these changes.
The best way to lose weight with PCOS naturally is a combination of healthy diet and exercise. There is no one single diet known to work best. But never skip meals to try to lose weight. That will throw off the insulin response when you do eat. When you work your muscles they will begin to burn the extra glucose in your body. That helps to keep your insulin levels down. If you are following a healthy diet and exercising regularly and still struggling to lose weight, then you may benefit from additional help from a medical weight loss clinic.
Medical treatment for PCOS
Medications used to treat diabetes, such as Metformin, are often prescribed for women with PCOS. Metformin works to lower insulin levels, and may help with weight loss. Metformin is not FDA-approved for the treatment of PCOS. Metformin may cause ovulation (release of an egg) to occur more frequently, so women who do not desire pregnancy should be on birth control. Gastrointestinal side effects, such as nausea, vomiting and diarrhea, are common. These side effects are improved by starting with a small dose of Metformin and gradually increasing the dose. The extended-release tablets can also help reduce the risk of GI side effects. There is a small risk of developing lactic acidosis, a shift in your electrolytes, and is usually seen patients with poorly controlled diabetes or kidney disease. Hypoglycemia, or low glucose, is rare.
Morbidly obese women with PCOS may benefit from weight-loss surgery, such as gastric bypass. Women who undergo weight-loss surgery will usually resume normal menses, and improve or reverse type 2 diabetes.
Treatment should be modified according to an individual patient’s needs. Talk with your provider to learn more.
This post was written by Michelle Roach, M.D., who leads the Polycystic Ovarian Syndrome Program at Vanderbilt University Medical Center. This program offers comprehensive, personalized care to help you manage your PCOS symptoms. Our care team also offers health screenings for women with PCOS to reduce your risk of developing other health problems.
Do you think you might have polycystic ovarian syndrome? Or are you having difficulty conceiving? Find out more by scheduling an appointment at the Vanderbilt Center for Women’s Health: (615) 343-5700.