Bariatric Surgery in the Management of Adolescent and Adult ObesePatients with Polycystic Ovarian Syndrome

Abstract

Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. Obesity in PCOS patients is associated with significant morbidities. Obesity in PCOS abrogates the menstrual cycle and fertility, and can independently increase the risk of metabolic syndrome and the latter’s long-term cardiac and health complications. The degree of obesity as reflected by the body mass index (BMI) can have a significant impact on the associated risk with its morbidities. Thus, weight reduction is highly encouraged for obese patients with PCOS as early as in adolescence to avoid long-term complications. Conservative methods of weight reduction, such as diet and lifestyle modifications, have been used in PCOS patients but their effects can be short-lived, especially in the morbidly obese populations. To that end, bariatric surgery has been proposed as an alternative modality for the treatment of obese patients with PCOS in order to decrease the risk of metabolic syndrome. Nevertheless, bariatric surgery utilization in the adolescent population of PCOS patients is still not well evaluated. Bariatric surgery is considered in patients with very high BMI levels and those patients who had multiple failed attempts of weight reduction using more conservative methods. In this review, we focused on the metabolic manifestations of PCOS and discussed studies highlighting the usage of bariatric surgery as an attempt to reduce weight in obese patients with PCOS with primary focus on the adolescent population.