The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery

Context: The polycystic ovary syndrome ( PCOS) is frequently associated with obesity. However, there are very few data about PCOS in morbid obesity, especially with regard to its evolution after bariatric surgery. Objective: The objective of this study was to evaluate the response of PCOS to the sustained and marked weight loss achieved by bariatric surgery in morbidly obese women. Design: This was a longitudinal prospective nonrandomized evaluation. Settings: The study was performed at an academic hospital. Patients: Thirty-six consecutive premenopausal women submitted to bariatric surgery were screened for PCOS, which was present in 17. Interventions: Bariatric surgery was performed. Main Outcome Measures: Hyperandrogenism, menstrual function, and insulin resistance were estimated before and at least 6 months after bariatric surgery in 12 patients with PCOS. Results: Weight loss (41 +/- 9 kg after 12 +/- 5 months) was paralleled by decreases in the hirsutism score (from 9.5 +/- 6.8 to 4.9 +/- 4.2; P = 0.001), total (69 +/- 32 to 42 +/- 19 ng/dl; P < 0.02) and free testosterone (from 1.6 +/- 0.7 to 0.6 +/- 0.3 ng/dl; P < 0.005), androstenedione (from 4.1 +/- 1.5 to 3.0 +/- 0.9 ng/ml; P < 0.02), and dehydroepiandrosterone sulfate (from 2000 +/- 1125 to 1353 +/- 759 ng/ml; P < 0.005); amelioration of insulin resistance estimated by homeostasis model assessment (from 6.0 +/- 3.0 to 1.6 +/- 1.0; P < 0.001); and restoration of regular menstrual cycles and/or ovulation in all patients. Conclusions: The PCOS is a frequent finding in women with morbid obesity and may resolve after weight loss induced by bariatric surgery.