Polycystic ovary syndrome and obesity by Maureen Busby- #obsmuk chat's blog 24th July


Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to one in five women of reproductive age [1]. PCOS is diagnosed according to The Rotterdam diagnostic criteria and is based on two of three features: infrequent periods or lack of ovulation, hyperandrogenism features such as excess facial hair or acne, and polycystic ovaries visible on a scan [2].  Obesity is unlikely to be a cause of PCOS as demonstrated by the prevalence of lean women with the condition.  However, having obesity does exacerbate the condition and increase the risk of other serious health problems [3].  Obesity is a common finding in PCOS with estimates of between 40% to 80% of women with PCOS having overweight or obesity [4]. PCOS is associated with several metabolic complications including pre-diabetes, Type II Diabetes and obesity [5].  Having PCOS also increases the risk of Heart Disease, Fatty Liver Disease and Uterine (womb) Cancer [6–8].  The etiology of the disease is not fully understood [9].  Treatment options vary due to the variable nature of the symptoms experienced.  Treatment options can include: - lifestyle management including diet, exercise, weight loss - pharmacological treatment including the contraceptive pill, insulin-sensitising agents such as metformin (not licensed in UK for non-diabetic patients), exenatide, orlistat, IVF, Clomifene, Letrozole (off-license), gonadotrophins, spironolactone, flutamide, finasteride, eflornithine cream, laser hair removal, acne treatments, statins. - Ovarian electrocautery/Laparascopic ovarian drilling - Bariatric surgery [10]. 
Please join us in our chat on Wednesday 26th July 2019 at 8pm UK time to discuss PCOS & Obesity.  The following questions will be discussed:
Question 1.
What is your understanding of PCOS, its causes and how it affects people? What are the long-term risks and what can be done to reduce them?
Question 2.
Why do patients with PCOS struggle with their weight? How common is obesity in relation to PCOS?
Question 3.
How does having obesity exacerbate PCOS symptoms? Question 4. What practical steps can you take to help? Which treatments are available for PCOS? What are the benefits of treatment of obesity in patients with PCOS?
Question 5. What is the role of bariatric surgery in the treatment of PCOS? Is there evidence of superiority of one bariatric procedure compared to the others?

About me
Maureen Busby is a MSc in Health Psychology Graduate whose research focus was PCOS and the Menopause.  Maureen has lived experience of PCOS and Obesity.
REFERENCES
[1]H. Teede, A. Deeks, L. Moran, Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan, BMC Med. 8 (2010). doi:10.1186/1741-7015-8-41.
[2]A. Neven, J. Laven, H. Teede, J. Boyle, A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines, Semin. Reprod. Med. 36 (2018) 005–012. doi:10.1055/s-0038-1668085.
[3]R.S. Legro, Obesity and PCOS: Implications for Diagnosis and Treatment, (2012). doi:10.1055/s-0032-1328878.
[4]S. Sam, Obesity and Polycystic Ovary Syndrome, (n.d.). doi:10.1089/obe.2007.0019.
[5]M. Insenser, M. Murri, R. del Campo, M.Á. Martínez-García, E. Fernández-Durán, H.F. Escobar-Morreale, Gut Microbiota and the Polycystic Ovary Syndrome: Influence of Sex, Sex Hormones, and Obesity, J. Clin. Endocrinol. Metab. 103 (2018) 2552–2562. doi:10.1210/jc.2017-02799.
[6]D. Glintborg, K.H. Rubin, M. Nybo, B. Abrahamsen, M. Andersen, Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome, Cardiovasc. Diabetol. 17 (2018) 37. doi:10.1186/s12933-018-0680-5.
[7]Z. Haoula, M. Salman, W. Atiomo, Evaluating the association between endometrial cancer and polycystic ovary syndrome, Hum. Reprod. 27 (2012) 1327–1331. doi:10.1093/humrep/des042.
[8]Z. Javed, M. Papageorgiou, H. Deshmukh, E.S. Kilpatrick, V. Mann, L. Corless, G. Abouda, A.S. Rigby, S.L. Atkin, T. Sathyapalan, A Randomized, Controlled Trial of Vitamin D Supplementation on Cardiovascular Risk Factors, Hormones, and Liver Markers in Women with Polycystic Ovary Syndrome, Nutrients. 11 (2019) 188. doi:10.3390/nu11010188.
[9]E. Spinedi, D.P. Cardinali, The Polycystic Ovary Syndrome and the Metabolic Syndrome: A Possible Chronobiotic-Cytoprotective Adjuvant Therapy., Int. J. Endocrinol. 2018 (2018) 1349868. doi:10.1155/2018/1349868.
[10]Long-term Consequences of Polycystic Ovary Syndrome, 2014. (accessed March 12, 2019).

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