Polycystic Ovarian Syndrome (PCOS) and Obesity

What is polycystic ovarian syndrome?

Polycystic Ovarian Syndrome (PCOS) is one of the most common reproductive conditions. 8-13% of women are affected by it, and it’s suspected 70% of affected women are undiagnosed1.

PCOS is because of a hormone imbalance in the ovaries. Women with PCOS usually have higher levels of insulin and/or androgens, which are male hormones. These hormones mean your ovaries and eggs don’t work normally.

Women with PCOS also often have enlarged ovaries with many small fluid-filled follicles on them.

What is the link between PCOS and obesity?

Obesity has a strong link with PCOS. Obesity can increase insulin resistance and can hyperandrogenism, which may increase the prevalence of PCOS1.

It’s not known whether obesity causes PCOS or PCOS causes obesity or whether both are true. Generally, women with PCOS are more likely to be overweight and obese1. They’re also more likely to gain weight2 and find it difficult to lose weight3.

What is the cause of PCOS?

Doctors aren’t exactly sure what causes PCOS. There is evidence that genes play a role, as do lifestyle choices and the environment4.

Many women with PCOS are insulin resistant5 which is also often caused by obesity.

It’s also more often seen in Indigenous women, possibly because of higher obesity and insulin resistance in these populations6.

What are the complications of PCOS?

PCOS is one of the leading causes of infertility in women. It can also increase the risk of you developing diabetes, cardiovascular disease and metabolic syndrome. There are links between PCOS and depression and sleep apnoea7.

There is also a two to six-fold increased risk of endometrial cancer for women with PCOS1 although the risk is still relatively low.

What is the treatment of PCOS?

If you have obesity and PCOS, it’s likely doctors will suggest weight loss as the first option 1 if possible.

Other treatments may include the oral contraceptive pill, medication to block hormones, insulin sensitising medications, or infertility medications.

Anxiety, Depression and Obesity

The research behind the science

1 International evidence based guideline for the assessment and management of polycystic ovary syndrome. Copyright Monash University, Melbourne Australia 2018. Available from https://www.monash.edu/__data/assets/pdf_file/0004/1412644/PCOS_Evidence-Based-Guidelines_20181009.pdf Accessed December 2021.

2 Teede, H.J., Joham, A.E., Paul, E., Moran, L.J., Loxton, D., Jolley, D. and Lombard, C. (2013), Longitudinal weight gain in women identified With polycystic ovary syndrome: Results of an observational study in young women. Obesity, 21: 1526-1532. https://doi.org/10.1002/oby.20213

3 Nasiri Amiri F, Ramezani Tehrani F, Simbar M, Montazeri A, Mohammadpour Thamtan RA. The experience of women affected by polycystic ovary syndrome: a qualitative study from iran. Int J Endocrinol Metab. 2014;12(2):e13612. Published 2014 Apr 1. doi:10.5812/ijem.13612 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013493/

4 Diamanti-Kandarakis, E., Kandarakis, H. & Legro, R.S. The role of genes and environment in the etiology of PCOS. Endocr30, 19–26 (2006). https://doi.org/10.1385/ENDO:30:1:19

5 Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance?. Fertil Steril. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277302/

6 Boyle JA, Cunningham J, O’Dea K, Dunbar T, Norman RJ. Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia. Med J Aust. 2012;196(1):62-66. doi:10.5694/mja11.10553 https://onlinelibrary.wiley.com/doi/10.5694/mja11.10553

7 Factsheet from American College of Obstetricians and Gynecologists June 2020 Available from https://www.acog.org/womens-health/faqs/polycystic-ovary-syndrome-pcos. Accessed December 2021.