Polycystic Ovary Syndrome and Obesity

Abstract

Polycystic Ovary Syndrome (PCOS) is a common condition in reproductive-age women. PCOS is characterized by both reproductive dysfunction and hyperandrogenemia. Importantly, PCOS is also associated with metabolic aberrations, including insulin resistance. There is a strong association between obesity and PCOS, based on epidemiology, aetiology and genetics studies. Increased adiposity worsens insulin resistance (which in turn results in compensatory hyperinsulinemia, with associated pleiotropic effects) and disrupts steroid metabolism, further enhancing androgenicity. Through these mechanisms, weight-gain unmasks PCOS in those women who are genetically predisposed. Conversely, even modest weight-loss of just 5 % body weight in obese women with PCOS often results in clinically meaningful improvements in reproductive, hyperandrogenic and metabolic dysfunction. Given inextricable interlinks between PCOS and obesity, novel therapies that promote weight-loss, including activation of brown adipose tissue, remain perhaps our most promising future therapeutic options for obese women with PCOS.