Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women, which happens due to the imbalance between estrogen and progesterone. Benign ovarian cysts develop around the ovaries. PCOS can affect menstrual cycle, fertility and physical appearance. But that’s not all.

If it is not treated well in time, PCOS will lead to diabetes and heart disease. Dyslipidema and hypertension are also seen. PCOS can influence lipid levels (triglycerides, cholesterol), and hence, the cardiac function. Studies suggest that the risk of cardiovascular diseases in PCOS women is higher than that in normal population. PCOS affected persons show insulin resistance, i.e., difficulty using insulin. This will increase blood glucose levels, increasing the risk of diabetes mellitus. Obesity is seen to be quite common in women affected by PCOS. Obesity and PCOS are inextricably related. Increased blood sugar levels, higher triglyceride levels, obesity can lead to metabolic abnormalities.

There is evidence of atherosclerosis by abnormal carotid intima-media thickness measurements in PCOS women. Intima-Media Thickness (IMT) is an indicator of atherosclerosis. In a study, lipid profiles, blood pressure, waist circumference, Body Mass Index and IMT of carotid artery were measured in PCOS patients. It was seen that women with PCOS have a greater carotid IMT and plaque and this is probably due to the adverse metabolic profile seen in PCOS.

How can PCOS be managed?

Women with PCOS will benefit from losing weight. This will help balance hormone levels and set the menstrual cycle right. The most common and first step in this direction is to monitor diet and introduce or increase physical activity.

However, dietary changes and physical activity undergone to control PCOS symptoms in women with morbid obesity, sometimes brings about only moderate weight loss, and, sometimes this weight is regained. This leads to treatment with oral contraceptives and insulin sensitizers. In most cases, unfortunately, the painful, discomforting and depressing symptoms of PCOS remain.

How does Bariatric Surgery help?

Bariatric surgery can help women with PCOS. After bariatric surgery, along with the obvious weight-loss results, blood sugar levels go down, related heart conditions improve, metabolic abnormalities are reduced. The weight reduction helps restore normal menstrual cycles and ovulation. Fertility improves.

PCOS women produce more androgens than normal and this extra androgen in the body leads to acne, hirutism, deeper voice, etc. Patients see an improvement in hirutism after surgery.

HbA1C also improved post-operatively within 3 months. Improvement in insulin resistance and associated metabolic disorders indicates how bariatric surgery helps PCOS women. The metabolic, hyperandrogenic and reproductive manifestations of this disorder in obese women can be managed efficiently through bariatric surgery.

Thought and consideration

Serious consideration is required before opting for surgical intervention to treat obesity, PCOS, diabetes or other morbidities. It is not a quick fix and calls for major changes in your life, apart from just dietary and lifestyle changes. Bariatric surgery does not guarantee resolving infertility issues or a cure for PCOS. However, if your medical condition has been assessed well by your doctor and you qualify for bariatric surgery, understand that bariatric surgery can help you control the severity of PCOS.