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Polycystic ovary syndrome (PCOS) and weight gain

Most women at some point have to contend with weight gain. But for women with polycystic ovary syndrome (PCOS), losing weight can become a constant struggle.

PCOS occurs when the ovaries don’t make enough hormones for the eggs to fully mature. Instead of releasing a mature egg during ovulation, some of the follicles in the ovaries turn into fluid-filled sacs called cysts. More than six out of every 10 women who have PCOS are also overweight.

While there is no cure for PCOS, losing weight can have a huge impact on many of the symptoms.

Why does polycystic ovary syndrome cause weight gain?

With PCOS, the body has more difficulty using the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition -- called insulin resistance -- can cause insulin and sugar -- glucose -- to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods -- and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen. That is where men tend to carry weight. So instead of having a pear shape, women with PCOS have more of an apple shape.

Abdominal fat is the most dangerous kind of fat. That’s because it increases the risks of heart disease and other health conditions.

What are the risks associated with gaining weight with polycystic ovary syndrome?

No matter what the cause, weight gain can be detrimental to your health. Women with PCOS are more likely to develop many of the problems associated with weight gain and insulin resistance, including:

All of these conditions can lead to heart disease. In fact, women with PCOS are four to seven times more likely to have a heart attack than women of the same age without the condition.

Experts think weight gain also helps trigger the symptoms of PCOS, such as menstrual abnormalities and acne.

What can I do to lose weight if I have polycystic ovary syndrome?

Losing weight not only can help you look better -- it can also make you feel better. When you have PCOS, shedding just 5-10% of your body weight can bring your periods back to normal. It can also help relieve some of the symptoms of polycystic ovary syndrome.

Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications.

To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index. Body mass index is also called BMI, and it is the ratio of your height to your weight.

Your doctor may also prescribe drug therapy. While there is no cure for PCOS, a variety of drugs are used in the management of different symptoms. These include:

  • A type of contraceptive pill which contains oestrogen and an anti-androgen (anti-male hormone) which can reduce excessive hair growth and improve acne.  
  • A cream that inhibits hair growth on the face in about 70% of women.
  • A water tablet (diuretic) called spironolactone which also has the effect of reducing excess hair growth.  
  • Metformin. This is a diabetes drug which is not actually licensed in the UK for use in PCOS but can be used “off license” if indicated. It helps the body use insulin more efficiently. It also reduces testosterone production. Some research has found that it can help obese women with PCOS lose weight.  
  • Your doctor may also prescribe drug treatments specifically to help you lose weight.
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