ORIGINAL ARTICLE   

Minerva Obstetrics and Gynecology 2023 June;75(3):251-9

DOI: 10.23736/S2724-606X.21.05011-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Quality of life improvements after bariatric surgery in reproductive age women with and without PCOS: a cohort study

Hester LACEY ¹ ✉, Stephanie ATTERSLEY-SMITH ^{2, 3}, Sophia STONE ², Martin WHYTE ³, Jill SHAWE ^{3, 4}, Kathryn HART ³

¹ Brighton and Sussex Medical School, Brighton University Hospitals Trust, Brighton, UK; ² University Hospitals Sussex NHS Foundation Trust, Department of Obstetrics and Gynecology, St Richard’s Hospital, Chichester, UK; ³ Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK; ⁴ Faculty of Health, University of Plymouth, Plymouth, UK

BACKGROUND: Obesity can negatively influence quality of life (QoL). Polycystic ovarian syndrome (PCOS), associated with obesity, presents with sub-fertility, hyperandrogenism, and/or insulin resistance. These features can also negatively influence QoL. This study aimed to determine whether bariatric surgery improves QoL in women of reproductive age, with and without PCOS. We hypothesized greater QoL improvements would be seen post-operatively in women with PCOS.
METHODS: Women undergoing bariatric surgery (N.=77) completed questionnaires exploring health-related quality of life (HR-QoL) prior to and at 3, 6 and 12 months post-surgery. Weight loss, symptoms, and association with change in QoL were assessed.
RESULTS: Bariatric surgery resulted in significant QoL improvements, independent of PCOS status. Oligo/amenorrhea was reported in 68% of women at baseline, decreasing to 35% by 12 months. Sixty-five percent of women whose menstrual irregularity resolved over follow-up had PCOS. Hirsutism was reported in 64% of women at baseline (all of whom had PCOS), decreasing to 19% by 12 months. Weight loss at 12-months was 45.8±20.7 kg for women without PCOS compared to 44.3±16.8 kg in women with PCOS (P=0.07). Weight loss was moderately associated with 12-month QoL improvements for both groups.
CONCLUSIONS: Bariatric surgery provides significant physical and psychological health benefits for women with obesity both with and without PCOS. Surgery can also ameliorate the clinical syndrome of PCOS, including oligomenorrhoea, hirsutism, and subfertility, with subsequent QoL benefits. Psychological support perioperatively may aid QoL outcomes by acknowledging factors influencing QoL beside absolute weight loss.

KEY WORDS: Bariatric surgery; Polycystic ovarian syndrome; Quality of life; Fertility