Bariatric surgery often overlooked as effective treatment for polycystic ovary syndrome

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Tuesday, November 15, 2022
Bariatric surgery often overlooked as effective treatment for PCOS
Polycystic ovary syndrome can lead to irregular periods and infertility. For obese women, bariatric surgery can reverse the condition in most cases.

PHILADELPHIA (WPVI) -- About one in 10 women of childbearing age faces polycystic ovary syndrome, or PCOS.

While medication or lifestyle changes have been the standard treatments, there's an unexpected approach that's been a big success.

It's the jolt some women hear as they struggle to have a baby - "You have PCOS."

Polycystic Ovary syndrome is a complex condition causing high levels of androgen - a male hormone.

Dr. Anna Zelivianskaia of Temple Health says PCOS causes multiple cysts on the ovaries, acne or oily skin, thinning hair on the head, and more -

"Signs of excess facial hair growth or excess growth in other areas, irregular ovulation, which often manifests as irregular periods," says Dr. Zelivianskaia.

"The majority of women with PCOS also suffer from obesity," she adds.

PCOS doesn't just present immediate concern, but long-term ones as well, such as heart disease and diabetes.

"Definitely these women are at higher risk for insulin resistance which has an increased risk of diabetes and increased risk of metabolic syndrome. It can also affect their lipid and cholesterol levels. And any of these abnormalities are then risk factors for, for heart and cardiovascular issues," says Dr. Zelivianskaia.

Treatment depends on a woman's age, the severity of her symptoms, her overall health, and whether she wants to get pregnant.

Birth control pills, intra-uterine devices, and other medications can address ovulation, excess body hair, and some future health risks.

If the woman is obese, "Then it's also important to counsel her on how impactful even a small amount of weight loss can be," adds Dr. Zelivianskaia.

In recent years, Dr. Charis Ripley-Hager says bariatric surgery has become a very powerful tool, improving ALL the symptoms.

One study of 2000 women showed that -

"About 45.6% of patients had PCOS preoperatively. And that went down to only 6.8% at one year postoperatively," says Dr. Charis Ripley-Hager, a Temple Health bariatric Surgeon.

"Menstrual irregularity went down from 56.2% to 7.7%," she adds.

Infertility also plunged from 18.2%, down to 4.3%.

Dr. Ripley-Hager says many women with PCOS qualify for bariatric surgery, but too few get it.

"A lot of physicians have, uh, don't know how to start that conversation. I think a lot of patients either are resistant to it, or don't know how to ask for that help,"

Dr. Ripley-Hager believes many gynecologists don't know yet about the PCOS-bariatric surgery connection. So women may need to seek out a specialist to start that conversation.