Improved Menstrual Function in Obese Women with Polycystic Ovary Syndrome after Behavioral Modification Intervention ‐ a Randomized Controlled Trial

Summary

Objective

Lifestyle intervention is the recommended first line treatment for overweight women with polycystic ovary syndrome (PCOS). However, the efficacy of lifestyle change in improving reproductive function is still unclear.

Design

A randomized controlled trial with allocation to a behavioral modification program (intervention) or minimal intervention (control) for four months with a follow‐up at 12 months.

Patients

68 women, aged 18‐40 years, BMI ≥ 27 kg/m², fulfilling all Rotterdam PCOS criteria.

Measurements

The primary outcome was improved menstrual regularity. Secondary outcomes were ovulation and pregnancy rates.

Results

At four months, the weight loss was significant in the intervention group (‐2.1%, P=.002), and non‐significant in the control group (‐1.0%). A higher proportion of patients in the intervention group improved menstrual regularity compared to the control group, mean difference 35% (95% CI 16% to 60%), P=.003. There was no difference in ovulation rate between groups. Logistic regression analysis showed that intervention was the only predictor of improved menstrual function, OR 3.9 (95% CI 1.3 to 11.9). At 12 months, a total of 54% of the women improved menstrual regularity compared to baseline (P=.000) and 43% (P=.000) had confirmed ovulation. 38% of the women wishing to become pregnant succeeded within one year of study completion.

Conclusions

This is the first randomized controlled trial in overweight women with PCOS showing efficacy in improving reproductive function following behavioral modification intervention in comparison with minimal intervention. Although extensive weight loss is difficult to achieve in these women, behavioral modification intervention can help improve reproductive function.

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