Effect of Weight Loss on Menstrual Function in Adolescents with Polycystic Ovary Syndrome

Study ObjectiveTo compare the effects of a hypocaloric low-fat diet with those of a very low carbohydrate diet on body mass index (BMI), waist circumference (WC), and menstrual function in overweight adolescent females with polycystic ovary syndrome (PCOS).DesignRandomized pilot trial of two diets in a prospective, 12-week study.SettingA hospital-based, academic adolescent medicine division.Participants24 females, age 12-22 years (mean 15.8 ± 2.2), with PCOS and a BMI above the 85th percentile for age (mean 35.7 ± 6.0 kg/m2).InterventionsNutrition counseling was given biweekly, and dietary compliance, menstrual history, and weight were recorded. WC was measured at the beginning and end of the study.Main Outcome MeasuresChanges in weight, BMI, WC, and improvement in menstrual function over the course of the study period.Results16 participants completed the study. 12 completers menstruated during the study period, 8 with regularity. The number of periods over 3 months increased from 0.6 ± 0.6 pre-treatment to 1.6 ± 1.3 post-treatment (P = 0.003). Overall, weight loss averaged 6.5% (P < 0.0001) and the WC decreased by an average of 5.7 ± 7.7 cm (P = 0.01). Those who lost weight were 3.4 times more likely to have improved menstrual function (P = 0.001). There were no statistically significant differences between the two groups.ConclusionsWeight loss is feasible in adolescents with PCOS and results in significant improvements in BMI, WC, and menstrual function. Weight management may be preferable as first-line treatment in adolescents, because it targets both the menstrual dysfunction and risk factors for long-term morbidity associated with PCOS.