Weight-loss interventions ‘useful tool’ to improve PCOS symptoms

Key takeaways:

• A range of weight-loss interventions improved certain symptoms of polycystic ovary syndrome compared with usual care.
• Weight loss did not improve hirsutism or PCOS-related quality of life.

Women with polycystic ovary syndrome who initiated any weight-loss intervention saw improvements in some glycemic and hormonal measures as well as improved menstrual frequency, data from a meta-analysis show.

“Weight-loss interventions seem to be a useful tool to help improve some of the markers and symptoms of PCOS,” Jadine H. Scragg, PhD, a researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford, U.K., told Healio. “We did not compare types of interventions, so we cannot say which is best. The mean weight losses were reasonably modest and it would seem that a range of interventions could be useful to help achieve this weight loss.”

For the meta-analysis, researchers analyzed randomized controlled trials with 1,529 participants conducted through June comparing interventions to reduce weight vs. usual care for people with PCOS, including 12 assessing behavioral interventions, nine comparing GLP-1 receptor agonists and eight assessing other weight-loss medications. The comparator intervention was usual care, defined as metformin, oral contraceptive pills, standard advice or a minimal intervention aimed at weight loss. Researchers assessed glycemic parameters, hormonal markers, menstrual frequency, hirsutism and PCOS-related quality of life measures.

The findings were published in Annals of Internal Medicine.

Researchers found that weight-loss interventions overall were associated with greater improvements in homeostasis model assessment for insulin resistance (mean difference, –0.45; 95% CI, –0.75 to –0.15]; I² = 24%), free androgen index (mean difference, –2.03; 95% CI, –3 to –1.07]; I² = 48%) and menstrual frequency (mean difference, 2.64; 95% CI, 0.65-4.63; I² = 43%). Weight-loss interventions were associated with greater increases in menstrual frequency (mean difference, 2.64 menses per year; 95% CI, 0.65-4.63; I² = 43%).

“To our knowledge, this is the first review to show a clinically significant association in improvement in menstrual frequency with weight-loss interventions, an important indicator of subsequent fertility and an important outcome for women,” the researchers wrote.

There was no evidence across studies that any weight-loss interventions were associated with improvements in hirsutism, PCOS-related quality of life or changes in other measured sex hormones; however, researchers acknowledged data were limited. There was also insufficient data to meta-analyze changes in ovulation or acne.

“Clinicians who support patients with PCOS might use these findings to refer patients to weight-loss services or to advise on the potential implications of weight-loss interventions for PCOS,” Scragg told Healio. “The people living with PCOS who we spoke to about our findings emphasized the need for greater support for weight loss and said that general advice to lose weight is unhelpful. We must ensure that there is good support for people looking to lose weight and an important next step could be working closely with patients with PCOS to determine the tailored support they might need.”

For more information:

Jadine H. Scragg, PhD, can be reached at jadine.scragg@phc.ox.ac.uk.