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Cited by 301Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsReproductive Biology and Fertility

Restoration of Reproductive Potential by Lifestyle Modification in Obese Polycystic Ovary Syndrome: Role of Insulin Sensitivity and Luteinizing Hormone

Huber-Buchholz, M.-M.·1999·Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.84.4.1470
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Abstract

Weight reduction and exercise have been shown to help with menstrual disturbance and infertility in obese women with polycystic ovary syndrome. We studied the relationship between insulin sensitivity and ovulation patterns in 18 infertile anovulatory obese polycystic ovary syndrome (PCOS) women (NO) with normal glucose tolerance, aged between 22–39 yr with a body mass index of 27–45 kg/m2, before and after a 6-month diet and exercise program. This program promotes healthy lifestyle factors, but does not lead to rapid weight loss. The anthropometric, metabolic, and endocrine factors of these subjects were compared to those of 10 age- and weight-matched PCOS women with regular monthly ovulation (RO). Before lifestyle modification, the anovulatory subjects had greater central obesity than regular ovulators, as assessed by percent central fat (NO, 45.7 ± 0.8%; RO, 42.2 ± 1.6%; P < 0.05), higher glucose increment after glucose challenge (NO, 10.1 ± 1.0 mmol/L; RO, 6.4 ± 1.1 mmol/L; P < 0.02), lower insulin sensitivity index (NO, 1.2 ± 0.2; RO, 2.8 ± 0.6 μmol/kg·min/pmol/L; P < 0.005), higher plasma LH (NO, 8.9 ± 0.9; RO, 4.6 ± 0.9 IU/L; P < 0.005), and lower plasma sex hormone-binding globulin (NO, 18.0 ± 2.5; RO, 27.8 ± 5.7 nmol/L; P < 0.05]. Anovulatory subjects were classified as responders (R) to the intervention if they regained ovulation during the study. As a result of intervention, R showed an 11% reduction in central fat, a 71% improvement in insulin sensitivity index, a 33% fall in fasting insulin levels, and a 39% reduction in LH levels. None of these parameters changed significantly in nonresponders (NR). At the end of the study, R had lower fasting insulin (R, 13.6 ± 1.7; NR, 23.0 ± 3.5 mU/L) and LH levels (R,5.0 ± 1.7; NR, 7.4± 1.4 IU/L), but similar androgen levels compared to NR. We conclude that lifestyle modification without rapid weight loss leads to a reduction of central fat and improved insulin sensitivity, which restores ovulation in overweight infertile women with PCOS. Lifestyle modification is the best initial management for obese women seeking to improve their reproductive function.

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  • Weight loss achieved through lifestyle management decreases abdominal fat, hyperandrogenism and IR and improves lipid profiles, ovulation, menstrual cyclicity, fertility, risk factors for DM2 and CVD and psychological health in women with PCOS who are overweight.

    “There is a large number of small, uncontrolled trials demonstrating that weight loss achieved through lifestyle management decreases abdominal fat, hyperandrogenism and IR and improves lipid profiles, ovulation, menstrual cyclicity, fertility, risk factors for DM2 and CVD and psychological health in women with PCOS who are overweight. 137-140”

    From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [138]

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Authors
Huber-Buchholz, M.-M.
Corresponding author
Huber-Buchholz, M.-M.
Venue
Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1999-04-01
Volume
84
Issue
4
Pages
1470-1474
ISSN
0021-972X (ISSN-L)
DOI
10.1210/jc.84.4.1470
OpenAlex
W4242137728
Cited by
269
References
0
Citations by year
2026: 1 · 2025: 5 · 2024: 9 · 2023: 5 · 2022: 8 · 2021: 12 · 2020: 9 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 6 · 2015: 11 · 2014: 3 · 2013: 8 · 2012: 6
FWCI
7.78
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Keywords
polycystic ovary syndrome, obesity, insulin sensitivity, luteinizing hormone, lifestyle modification, diet and exercise, anovulation, ovulation induction, abdominal obesity, sex hormone-binding globulin, insulin resistance, infertility, weight loss, menstrual irregularity, insulin sensitivity index, fasting insulin, glucose tolerance, insulin resistance index

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