The Link Between Obesity and Polycystic Ovary Syndrome (PCOS)

Women with PCOS are more likely to be obese, and vice versa.

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Polycystic ovary syndrome (PCOS) affects about one in 10 women between ages 15 and 44 in the United States, according to the Department of Health and Human Services (DHHS). Curiously, over half of those women with PCOS are overweight or have obesity.

This relationship between PCOS and obesity is complicated and not well understood. It’s unclear if one causes the other. For example, being overweight is associated with PCOS, but PCOS also affects many women who are at a normal weight. Plus, there are many women who are overweight who do not have PCOS.

PCOS and its Symptoms

PCOS is not a straightforward or easy condition. It is considered a collection of symptoms that can include:

  • Irregular periods or no periods: This can last weeks or months. This absence of menstruation is one of the reasons that PCOS is one of the most common causes of infertility.
  • Higher than normal levels of “male” hormones: This can result in excess hair on the face, body, acne, or thinning scalp hair.
  • Weight gain: You can also have difficulty losing weight.
  • Darkening of skin: You may develop darkened skin along creases of the neck, groin, and breasts.
  • A change in the ovaries: You can develop multiple cysts on one or both ovaries. The appearance is sometimes described as a “string of pearls” on the ovaries.

Learn more about symptoms of PCOS here.

Does Obesity Cause PCOS?

Researchers don’t actually know what causes PCOS. That’s why it’s called a “syndrome,” which is what doctors label conditions that don’t have a clear-cut cause. (Learn more about the differences between syndromes and diseases here.)

Here’s what researchers do know: Women with PCOS often produce too much insulin or are insulin resistant. Their bodies can produce insulin but not use it efficiently, which can increase the risk for type 2 diabetes. More than half of women with PCOS also have type 2 diabetes by the age of 40, according to DHHS. (Learn more about the link between PCOS and diabetes here.)

This is also a confusing relationship, however. Obesity increases the risk of insulin resistance, and insulin resistance can lead to weight gain (or make it more difficult to lose weight). Therefore, it’s hard to say which causes which.

Additional health problems often pop up with women who have PCOS, including:

  • Heart disease
  • High blood pressure
  • High cholesterol
  • Sleep apnea
  • Diabetes
  • Gestational diabetes (diabetes while pregnant)
  • Stroke

Many of these are also more common in women with obesity but don’t have PCOS. In women with PCOS, obesity makes these health problems more common.

What You Can Do

The point is, doctors don’t yet know what causes PCOS, and the role that obesity plays. However, it’s clear that there is some correlation between the two.

PCOS is definitely treatable, but it depends what stage you are at in life. If you are not trying to get pregnant, your doctor might recommend treating your PCOS with insulin-sensitizing medicine or birth control. This is not safe if you are trying to get pregnant. Your doctor will use other medications to target weight loss and to regulate your periods, if that is the case.

Talk to your doctor if you think you have PCOS and want to get tested. Together, you can decide the best course of action.