Lifestyle changes in women with Polycystic Ovary Syndrome

Moran, Lisa J.; Hutchinson, Sharon; Norman, Rob; Teede, Helena

doi:10.1002/14651858.cd007506

Cited by 163 publications

(212 citation statements)

References 24 publications

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“…The anthropometric improvements for participants in the test group reclassified for many of these women to class 1, with a moderate risk for developing obesity-related health complications. In light of the limitations for lifestyle intervention for overweight women with PCOS (Moran et al, 2011), such marked changes over the study duration with both specific gynaecological and mental health improvements are an important finding. There were no serious adverse events during the trial, and non-serious adverse effects were substantially fewer compared with the pharmaceutical interventions clomiphene and metformin for managing PCOS (Legro et al, 2007a, 2007b, Tang et al, 2012.…”

Section: Discussionmentioning

confidence: 99%

Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

Arentz

Smith

Abbott

et al. 2017

Phytotherapy Research

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Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first‐line intervention; however, there are barriers to success for this form of self‐care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. All participants were helped to construct a personalized lifestyle plan. The herbal intervention consisted of two tablets. Tablet 1 contained Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum and Paeonia lactiflora. Tablet 2 contained Tribulus terrestris. The primary outcome was oligomenorrhoea/amenorrhoea. Secondary outcomes were hormones; anthropometry; quality of life; depression, anxiety and stress; pregnancy; birth outcomes; and safety. One hundred and twenty‐two women gave their consent. At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3–42.6, p < 0.01) compared with controls, estimated as a large effect (ηp 2 = 0.11). Other significant improvements were found for body mass index (p < 0.01); insulin (p = 0.02) and luteinizing hormone (p = 0.04); blood pressure (p = 0.01); quality of life (p < 0.01); depression, anxiety and stress (p < 0.01); and pregnancy rates (p = 0.01). This trial provides evidence of improved effectiveness and safety for lifestyle intervention when combined with herbal medicines in women with PCOS. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd

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Section: Discussionmentioning

confidence: 99%

Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

Arentz

Smith

Abbott

et al. 2017

Phytotherapy Research

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“…This highlights the importance of screening, detection, and management of both overweight and obesity in the treatment of PCOS. Lifestyle modification is recommended as a key initial treatment strategy in overweight and obese women with PCOS (113,114) and improves SHBG, hyperandrogenism, weight, waist circumference, insulin resistance and psychological function (114)(115)(116)(117)(118)(119)(120)(121). Lifestyle interventions are also effective in preventing the development of chronic diseases such as type 2 diabetes in the general population (122).…”

Section: Clinical Implications Research Implications and Future Dirementioning

confidence: 99%

The effect of obesity on polycystic ovary syndrome: a systematic review and meta‐analysis

et al. 2012

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While many women with polycystic ovary syndrome (PCOS) are overweight, obese or centrally obese, the effect of excess weight on the outcomes of PCOS is inconsistent. The review aimed to assess the effects of overweight, obesity and central obesity on the reproductive, metabolic and psychological features of PCOS. MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL) and PSYCINFO were searched for studies reporting outcomes according to body mass index categories or body fat distribution. Data were presented as mean difference or risk ratio (95% confidence interval). This review included 30 eligible studies. Overweight or obese women with PCOS had decreased sex hormone-binding globulin (SHBG), increased total testosterone, free androgen index, hirsutism, fasting glucose, fasting insulin, homeostatic model assessment-insulin resistance index and worsened lipid profile. Obesity significantly worsened all metabolic and reproductive outcomes measured except for hirsutism when compared to normal weight women with PCOS. Overweight women had no differences in total testosterone, hirsutism, total-cholesterol and low-density lipoprotein-cholesterol compared to normal weight women and no differences in SHBG and total testosterone compared to obese women. Central obesity was associated with higher fasting insulin levels. These results suggest that prevention and treatment of obesity is important for the management of PCOS.

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“…Obesity and greater abdominal adiposity are also typical of PCOS and may accentuate reproductive and metabolic issues (8)(9)(10)(11)(12)(13)(14)(15). Therefore, lifestyle measures for weight loss are the first-line treatment in obese women with PCOS (12,16,17). However, lifestyle changes may not be sufficient to promote significant weight loss, and pharmaceutical interven-tions may be required (18).…”

Section: Introductionmentioning

confidence: 99%

Effects of orlistat vs. metformin on weight loss-related clinical variables in women with PCOS: systematic review and meta-analysis

et al. 2016

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Aims: The aim of this study was to assess the effects of orlistat on weight lossrelated clinical variables in overweight/obese women with polycystic ovary syndrome (PCOS) and to compare treatment with orlistat vs. metformin in this group. Methods: We conducted a systematic review and meta-analysis of the evidence about the use of orlistat in women with PCOS. We searched the literature published until May 2015 in MEDLINE, Cochrane Central Register of Controlled Trials and LILACS. Results: Of 3951 studies identified, nine were included in the systematic review (three prospective, non-randomised studies and six randomised control trials). Eight studies used the Rotterdam criteria and 1 used NIH criteria to diagnose PCOS. Data suggest that orlistat promotes a significant reduction in BMI/ weight in overweight/obese PCOS women. Eight studies evaluated orlistat impact on testosterone. Seven reported an improvement in testosterone levels. Eight studies evaluated impact on insulin resistance, and five reported improvement. Finally, five studies evaluated impact on lipid profile, and four reported improvement. Three randomised control trials were included in the fixed effects model meta-analysis for a total of 121 women with PCOS. Orlistat and metformin had similar positive effects on BMI (À0.65%, 95% CI: À2.03 to 0.73), HOMA (À3.60%, 95% CI: À16.99 to 9.78), testosterone (À2.08%, 95% CI: À13.08 to 8.93) and insulin (À5.51%, 95% CI: À22.27 to 11.26). Conclusion(s): The present results suggest that orlistat leads to significant reduction in BMI/body weight in PCOS. In addition, the available evidence indicates that orlistat and metformin have similar effects in reducing BMI, HOMA, testosterone and insulin in overweight/obese PCOS women.This study was registered in PROSPERO under number CRD42014012877. Review criteria• We conducted a systematic review and metaanalysis of the evidence about the effect of orlistat on weight, BMI, androgens and insulin resistance in women with polycystic ovary syndrome.• We systematically searched literature published until May 2015 in electronic databases MEDLINE, Cochrane Central Register of Controlled Trials and LILACS.• We conducted a descriptive systematic review and a fixed effects model meta-analysis and evaluated heterogeneity using the I 2 statistics and Cochran's Q test. Message for the clinic• Orlistat leads to significant reduction in BMI/body weight in overweight/obese PCOS.• Orlistat and metformin have similar effects in reducing BMI, testosterone and insulin/HOMA in overweight/obese PCOS women.

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Lifestyle changes in women with Polycystic Ovary Syndrome

Abstract: Lifestyle changes in women with polycystic ovary syndrome.

Cited by 163 publications

References 24 publications

Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

The effect of obesity on polycystic ovary syndrome: a systematic review and meta‐analysis

Effects of orlistat vs. metformin on weight loss-related clinical variables in women with PCOS: systematic review and meta-analysis

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