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Role of Surgery in the Management of PCOS: Rationale and Considerations for Bariatric Surgery

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Polycystic Ovary Syndrome

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Abstract

Obesity is a major determinant for the association of polycystic ovary syndrome (PCOS) with chronic disorders such as type 2 diabetes, the metabolic syndrome, hypertension, low-grade chronic inflammation, and a risk for cardiovascular disease. Metabolic prevention in women with PCOS should start as early as possible, to prevent long-term morbidity, and hence a need for an early diagnosis of this disorder. Among preventive strategies that can minimize long-term morbidity in women with PCOS, those promoting a healthy lifestyle based on diet, regular exercise, and smoking cessation are possibly the most effective but also the most difficult to achieve. Indeed, classic strategies that address obesity by lifestyle modification and dieting are seldom successful in the long term, especially in women with severe obesity. In selected cases, timely access to metabolic surgery in severely obese women not only allows avoidance of long-term risks but the consequent weight loss also may resolve signs and symptoms of PCOS, restoring ovarian function and fertility. The choice of bariatric procedure should consider the severity of obesity, and patients must be counseled regarding the possibility of a future pregnancy, as fertility may be restored by the sustained and marked weight loss usually attained after bariatric surgery.

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Acknowledgments

Supported by grants FIS PI080944 and PI110357 and CIBER Diabetes y Enfermedades Metabólicas Asociadas CB07/08/0005, from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III, Spain.

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Authors and Affiliations

  1. Department of Endocrinology, Universidad de Alcalá and Hospital Universitario Ramón y Cajal, Carretera de Colmenar km 9,1, Madrid, E-28034, Spain

    Héctor F. Escobar-Morreale M.D., Ph.D.

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  1. Héctor F. Escobar-Morreale M.D., Ph.D.
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Correspondence to Héctor F. Escobar-Morreale M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine Program for Polycystic Ovary Syndrome Yale Reproductive Endocrinology, New Haven, Connecticut, USA

    Lubna Pal

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Escobar-Morreale, H.F. (2014). Role of Surgery in the Management of PCOS: Rationale and Considerations for Bariatric Surgery. In: Pal, L. (eds) Polycystic Ovary Syndrome. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8394-6_16

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  • DOI: https://doi.org/10.1007/978-1-4614-8394-6_16

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