The Relationship Between Obesity and Polycystic Ovary Syndrome: Pathophysiology, Clinical Consequences, and Management, A Review.
DOI:
https://doi.org/10.12775/QS.2026.66.74010Keywords
Polycystic Ovary Syndrome, PCOS, Obesity, Metabolic effects, Clinical Consequences, Lifestyle changes, Therapeutic ManagementsAbstract
Background. Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and one of the leading causes of infertility. Insulin resistance plays a central role in its pathophysiology and leads to hyperinsulinemia, which is associated with an increased risk obesity in women with PCOS. Obesity in women with PCOS is associated with a more severe clinical phenotype, including increased risk of infertility, reduced response to ovulation induction, greater psychological burden, and impaired quality of life. First line management consists of lifestyle modification to reduce the risks of complications. The relationship between the multisystemic metabolic disorders, obesity and PCOS, is bidirectional and complex, with insulin resistance and hyperinsulinemia acting as key mediators linking the two conditions.
Aim. This review critically examines the relationship between obesity and PCOS, focusing on underlying pathophysiological mechanisms, clinical consequences, and current and emerging management strategies.
Material and methods. PubMed was used for the research of relevant studies with different combination of keywords; obesity and PCOS, management in obese PCOS women, complications in PCOS, therapeutic management in PCOS, therapeutic management in obese PCOS patients, PCOS and infertility, obesity and infertility and PCOS and lifestyle changes.
Results. The available evidence indicates that obesity is a major modifier of PCOS severity, exacerbating insulin resistance, metabolic dysfunction, infertility and psychological burden. Emerging therapies, including GLP-1 receptor agonists, alpha-lipoic acid, myo-inositol, and D-chiro-inositol, show promising effects on metabolic and reproductive outcomes, although current evidence is limited and heterogeneous
Conclusions. While emerging therapies demonstrate promising short-term benefits, lifestyle modification remains the cornerstone of management.
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