Endocrine Abstracts

Introduction: Weight loss is a mainstay in the treatment of polycystic ovary syndrome (PCOS). While the cause of this complex endocrine disorder remains unknown, it’s approved that weight loss improves symptoms of PCOS. We report a case of a patient with PCOS. Her symptoms disappeared totally after losing 50kg

Case report: In 2005, a 16-year-old girl presented for evaluation of spaniomenorrhoea and obesity. Physical examination showed a weight of 88 kg, a body mass index (BMI) of 37.5 kg/m², a waist circumference of 85 cm and a normal blood pressure (110/80 cmHg). The patient had no clinical signs of hyperandrogenism. Serum testosterone and luteinizing hormone levels were elevated, while follicle-stimulating hormone, prolactin and 17-OH progesterone levels were normal. Fasting blood glucose, oral glucosetolerance test and serum lipid profile were normal. Pelvic ultrasound showed bilateral polycystic ovaries. There were no clinical signs of Cushing syndrome. The diagnosis of PCOS was established. She was evaluated by a nutritional therapist and given lifestyle advice to reduce weight and increase physical activity. Metformin 1.7 g/day (850 mg*2) was started in order to improve insulin sensitivity.

Within 2 years, there was a 20 kg weight reduction and her BMI decreased to 27.9 kg/m². Menses were normal without progesterone medication during 3 years. But thereafter the patient no longer followed life style rules, she gained weight to 102 kg in 3 years (BMI:42.3 Kg/m²). She presented for obesity and secondary amenorrhea (since 6 months). Lifestyle changes and metformin therapy were reapplied.

Now, 2 years after lifestyle changes and metformin therapy, the patient weights 52 kg (BMI: 24.3 kg/m²). She has normal ovulatory cycles and normal testosterone.

Conclusions: Our case illustrates the close relationship between overweight and PCOS. Therefore, lifestyle changes should be the first-line intervention in these patients, especially in presence of obesity.