Can PCOS women have great results with WLS?

I'm having the VSG on Sept 14 but saw a post on that board from someone saying we will have a lot tougher time losing and keeping it off so I feel like why am I even doing this then? My doctor never said a word about it and my GYN knows my history and is all excited and the surgery and never said anything like that either. So can we be just as successful??

 I'm not sure where you read that, but that information isinaccurate. My surgeon has stated that his patients lose 70% off their excess weight. Getting to 100% is our responsibility with exercise and following the NUTs eating plan.

I have read some debate over this.  PCOS is associated with obesity, so if you are obese your likelyhood of having PCOS is higher.  Now, with that said, there is disaggreement over which came first the chicken or the egg.  I have heard some say obesity causes PCOS, I have heard some say PCOS causes obesity, and I have heard that it is neither caused by or a cause of but rather a symptom of metabolic syndrome that is part of the vicious cycle of obesity.  Once you start gaining so much weight metabolic changes can start taking place that make your body function differently and change the interactions of hormones like estrogen and insulin and make weight loss more difficult.

Many doctors believe that if you break the cycle through weight loss (which is normally more difficult if you have PCOS) then once you get rid of the metabolic syndrome you will no longer have symptoms of PCOS.  I have not seen where PCOS is shown to slow weight loss after WLS.  Now, these are some of the things I have heard.  My problem with some of that though is that not everyone who has PCOS is obese, so I wouldn't think would help for someone who had PCOS before they became obese (jsut my opinion). 

I have heard a lot of successful WLS patients, say that there cycle became regular after they started losing weight.  I didn't develop PCOS until I was obese.  After I had my daughter I was obese, and had had gestational diabetes and as the years krept by I developed hypothyroid and type 2 diabetes.  So, personally for me, I am hopefull that the WLS will help rid me of PCOS and metabolic syndrome.  I will say though that my experience so far has been a little rough.  After RNY I had a period that lasted 3 months.  We tried meds, BCP, and after a biopsy showed uterine polyps I had a D&C that got rid of the polyps and stopped the period.  My polyps were benign and my GYN does not think they will come back since I am losing so much weight.  Uterine polyps are associated with PCOS and high levels of circulating estrogen (which obese women often have).  I never had any symptoms of these polyps until I started losing weight, but I am glad I did so I could get rid of them.  My GYN seems to think things are going to normalize in the hormone department as I lose this weight and i really do too.

PCOS can not be cured only treated. It affects both normal and obese women, just more obese women get diagnosed. Just last week I had a long conversation with my OBGYN on this.

The major reason the heavier women with PCOS have such a hard time losing weight is because of the insulin resistance it causes and metabolic changes.

Now don't anyone get offended about this or their panties in a bunch but it is true.

VSG/ Lap-bands- while a tool to help you lose weight are usually not strong enough as a stand alone for someone with PCOS. They do nothing to change your metabolism. All they do is restrict food intake.

RNY- Does supply some change to the metabolism, but only for a few years. After that your "diet" and eating habits are to keep the weight off. And your metabolism can/not always revert back to its "piss poor" status once the malabsorption aspect of your surgery wears off roughly 2 years out (not always true, if distal you do usually have malabsorption for life just not DS strong).

DS- Supplies permanent changes to your metabolism and with a 98% cure rate of diabetes, usually PCOS induced insulin resistance is eliminated completely. Thus not having to worry to much about regain. Obviously we all need to follow the rules of our surgeries as they are all different!

My OBGYN is very WLS friendly. The other symptoms will minimize during the honeymoon stages of WL because fat stores estrogen, so as fat is lost estrogen is released and it stabilizes your hormones. Which is why women are more fertile during those first 2 years after WLS.

BUT at 5 years post-op all my PCOS symptoms are far from gone. Gradually the 5 o'clock shadow has come back, definite hormone imbalance, WLS affects your food intake...not hormonal imbalances which is what causes PCOS. So once your weight is stable your body will eventually feel the effects of the once again higher than normal testosterone levels, nothing was done to your body to affect that. So my insulin and metabolism issues are taken care of but I had to be put on a new BC just to up my female hormones and on a wonderful dose of another med to inhibit testosterone production.

Luckily I don't want children because well, my chances are not good at all. Even with fertility treatments and the such.

So it comes down to PCOS never goes away, and WLS does what is supposed to...help you lose weight not much more. As we know it doesn't fix your brain so why would it fix a hormone imbalance.

Not all GYN's or published literature agree on what you are saying.  Some do, some don't.  Most articles carefully phrase the relationship between PCOS and metabolic disturbances as "associated" rather than "caused by".  Associated means that they see these things happening together, but not necessarily being able to prove that one causes the other.  I respect your opinion and experiences, but I have heard the opposite experiences as well.  Personally I don't think they know enough about the balance of hormones in the body to definitely say what causes PCOS.  As far as I have read they only know with any certainty what associated symptoms qualify you as higher risk, not the cause.  Similarly with uterine polyps, they are associated with PCOS and with high levels of estrogen, but they are unable to determine if this is causing the polyps because it could be another source causing both symptoms.  I am still hopefull, but I do realize that doctors and science are far from figuring it all out and I do take all the info I read with a grain of salt.

Hi,
I was diagnosed with PCOS years ago, back when they called it "Stein~levanthol" sydrome as I recall.  Anyway, I was losing top of head hair, growing a belly and a mustache and beard with man sized testerone levels.  My periods were highly irregular and I had an ovarian cyst the size of a "ruby red grapefuit" removed which all but destoyed that ovary.  Nontheless, after going on Metformin as a treatment for PCOS, my periods became like clockwork...every 28 days for a decade and this lasted until I recently went through menopause.  The hair on my head stopped falling out, the hair on my face is still there but shaved daily and I have very normal testosterone levels for a lady now.  Yeah!
I have progressed into diabetes and am now on 2 types of insulin and 3 oral meds for diabetes with difficult control.  I am 5'4" and about 220.  I am having RNY to help me shed the belly with all that toxic fat and have better control of the diabetes.
Just wanted to tell you that Metformin helped me so much with the PCOS and testosterone levels.  Maybe this is something to try?
Good Luck!

I think you are confusing  "metbolic change" with "malabsorbtion". The RNY provides malabsorbtion for a period of time and DS'ers malabsorb forever. Malabsorption doesn't result in metabolic change, it results in less calories absorbed. Metabolism is a very different mechanism that is exremely complex. DS (and RNY for that matter) diabetes cure rates aren't related to metabolic change, they are related to nutirional intake and absorption change. Same goes with PCOS, which is largely believed at this point to be caused by insulin resistance (which both causes and is worsened by obesity) rather than the other way around. Rapid and massive weight loss will undo the escalation of PCOS by scaling back the obesity, and nutritional intake and absorption will help to contain the insulin resistance over time. That doesn't mean that there has been any underlying metabolic cure. 

I'm not confusing them. The malasorbtion procedures do change a persons metabolism, people do it with yo-yo diets, WLS in no different in changing it. The RNY temporarily the DS permently. There are plenty of peer reviewed articles that say and show this. Diabetes is ,as you said, not part of metabolism, but with the RNY since most is temporary malabsorption the diabetes is strictly in remission. The DS is considered a cure for type 2.

And PCOS they are finding has 2 driving factors either insulin resistance or hormonal. So in either case PCOS can only be treated and the DS is the best to get rid of the problem of insulin resistance because of malabsorption and because of the change in metabolism keeping the weight off is much easier. I'm not insulin resistant, and wasn't pre-op, my PCOS was hormone driven. Jillian Micheals has PCOS, and last time I knew she doesn't have a scrap of fat on her and she doesn't have insulin resistance either. My insulin is just fine, but my PCOS is still here. And its hormone driven.

I was diagnosed with PCOS several years before my RNY. It has been seven years since my RNY. During those years, I hit plateau after plateau. I feel that the plateaus were because of the PCOS fighting with the RNY. But, as time went by, my metabolism speeded up, and won out. I reached my goal weight just last year. It was HARD when those numbers didn't budge for (sometimes) months.  I often went on an all liquid diet, and sometimes that helped to break the plateau.  I stuck with the program, worked with my TOOL, and got through each plateau (finally). The thing that I will say, is, don't let plateaus discourage you - no matter how long they last. Find out what works for you.

 I can tell you being a little over 3 years out of RNY and post Hysterectomy, I still am very insulin intolerant, when I eat one carb its like I had 10 instead, I still have many other symptoms of PCOS, thinning hair, facial hair, hyper pigmentation, it didnt magically go away just cause I wasnt obese anymore.  The surgery, any of them, is a tool you have to use it and keep using it to get the results you want, Pcos gets better it doesnt get cured, at least in my experience.