PCOS is a common health issue found around the world that affects up to 10 million people. PCOS is found in females and is a disorder of the endocrine system – aka hormonal imbalance. Many females who consider bariatric surgery are doing so in order to increase their chances of pregnancy.
It has been difficult to pinpoint the exact cause of PCOS but many health professionals and scientists believe that it is a combination of genetics and lifestyle factors such as diet, activity status, etc. You are more likely to have PCOS if a family member like a mother or sister has it as well.
There are a handful of hormones that are involved in this condition: androgens, insulin and progesterone. The androgens are usually responsible for the common unwanted side effects of excess hair growth, cystic acne, increased hair thinning and irregular menstrual cycles. The body is not as receptive to insulin with PCOS and makes it difficult for the body to keep blood sugar levels under control. Higher insulin levels over time can contribute to increased androgens in the body. This can also eventually lead to pre-diabetes or type II diabetes if not controlled. Lastly, progesterone is most commonly known from pregnancy, but it also contributes to irregular menstrual cycles.
What are the signs of PCOS?
Unfortunately, PCOS can go undiagnosed for years as the symptoms are often attributed to other health conditions such as hyperthyroidism, pre-DM and DM.
Common symptoms are: irregular periods, excess facial hair (hirsutism), cystic acne, weight gain, thinning hair, fatigue, and infertility.
PCOS is diagnosed through lab work and analysis of symptoms reported by the patient.
Weight loss is one of the first line treatment options for women with PCOS. For those who have failed with traditional weight loss programs, bariatric surgery is a promising option for that population.
Medications such as birth control options such as the pill, anti-androgens and medications to help with increasing insulin sensitivity such as metformin. Medications are used in conjunction with a healthy diet and exercise to maximize their effects.
How does Bariatric surgery help with PCOS?
Up to 65% of PCOS patients suffer from obesity and have experienced failed weight loss attempts through their lifetimes.
Bariatric surgery breaks down the barrier of losing weight for those who have struggled with their weight. It physical reduces the amount you can consume, reduces the amount of ghrelin (hunger hormone) that is produced, causes malabsorption of nutrients/calories (RNYGB) and there are various changes in gut hormones that help with satiety, blood sugar regulation, etc. A weight loss of 5-10% of total body weight improves blood sugar control, insulin sensitivity, inflammation, regulates the menstrual cycle and more.
In 2017, “the American Society for Metabolic and Bariatric Surgery, along with the American College of Obstetricians and Gynecologists and the Obesity Society, endorsed bariatric surgery as a safe and effective treatment for women struggling with obesity and infertility.”