Raised body mass index (BMI) is seen in 95% of PCOS patients, which is characterised by hyperandrogenaemia, both clinically and biochemically. Weight loss, using calorie restricted diets, have previously been successful in improving androgen profiles and also restoring fertility in obese PCOS patients. A CB1 cannabinoid receptor antagonist, rimonabant is effective in achieving weight loss in subjects with a BMI >27 kg/m.
This study aimed to investigate the effects of weight loss, following treatment with rimonabant, on overweight and obese women with PCOS.
Study subjects (n=12) with PCOS (Rotterdam Criteria), age 1842 years, and BMI >30 kg/m2, were enrolled to the study from a general endocrine clinic. Menstrual history, assessment of weight, androgen profile, gonadotrophins and oestrogen were taken prior to and following commencement of rimonabant (at 1 month, 3 months and 6 months).
Following administration of rimonabant (20 mg), significant weight loss was observed in study subjects. Significant reductions were seen in androgen and oestradiol concentrations. LH:FSH also improved.
|Mean of difference||P|
|Free testosterone index||−5.56±1.81 nmol/l||0.02|
In conclusion, rimonabant treatment successfully reduces weight and improves hormonal profiles in obese patients with PCOS. While these improvements may be attributed to weight loss alone, further study is required to investigate additional endocannabinoid effects on the female gonadal axis.