MBS can improve reproductive health of women living with obesity

Metabolic and bariatric surgery improves menstrual cycle frequency and symptoms of polycystic ovaries in women living with obesity, according to a study from the University of Surrey. The research team recommends that preconception care and reproductive counselling be made available to women who undergo this weight-loss surgery to help improve their reproductive health.

During the study, Surrey researchers investigated the impact of metabolic surgery on the menstrual cycle, hormones and reproductive health of women ages 18–45 who lived with obesity. To learn more, researchers analysed data over 24 months from 84 women who underwent bariatric surgery (49 gastric bypass and 35 gastric sleeve) and 18 women living with obesity who did not undergo surgery.

Researchers found that at 12 and 24 months after surgery, the average weight loss among women was more than 30 kilograms (66 pounds). Interestingly, after surgery, the number of women who had polycystic ovaries, which are known to affect fertility, was significantly reduced and persisted in only 10% of women with the condition after 24 months.

Women also reported a resolution of clinical hirsutism (excess body hair), a common symptom of polycystic ovaries, by 12 months. The researchers also found that women who had previously experienced irregular periods reported a more regular cycle after surgery.

"A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years,” said Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, “So much remains unknown about the impact of this type of surgery on women who are planning to have children. This raises the question of when the ideal time after surgery is to conceive."

In addition, researchers noted that following surgery, 17 women had healthy pregnancies. Although not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.

"What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery,” added Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey. "Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity. By reducing this, what we have seen is that it can lead to improvements without the need for medication. We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility."

The findings were featured in the paper, ‘Menstrual and Reproductive Function Before and After Metabolic Bariatric Surgery’, published in Obesity Surgery.