Endocrine Abstracts

Introduction: Women with polycystic ovary syndrome (PCOS) have a higher prevalence of obesity and weight gain. Obesity negatively impacts the fertility, mental wellbeing and long term health of women with PCOS. The 2023 international guidelines for the management of PCOS suggest that GLP1 receptor agonists could be considered, but highlight a lack of evidence for medical obesity treatment in women with PCOS. Previous studies showed that interventions which reduce weight by as little as 5% of total body weight have metabolic, reproductive and psychological benefits in women with PCOS.

Methods: We retrospectively collected data on 48 obese women with PCOS attending a specialist reproductive endocrinology clinic who were prescribed GLP1 agonist therapy. All women were provided with contraceptive advice. All women were also given dietary advice by clinicians, although access to specialist dietetic support was not routinely available.

Results: Mean age of women was 32.2 ± 7.5 years. Median duration of GLP1 agonist therapy was 12 (8-17) months. 94% of the women used semaglutide and 47% were also taking metformin. Average weight loss with GLP1 agonist therapy was 11.2 ± 8.5 kg (P<0.0001). Median % total body weight loss was 11% (IQR 4.8-14.7%). 77% of women lost more than 5% and 55% lost more than 10% of their total body weight. Mean systolic blood pressure reduced from 131 ± 12 mmHg to 123 ± 11 mmHg (P=0.02). Mean diastolic blood pressure remained unchanged 82 vs 81 mmHg (±7) mmHg. Mean HbA1C reduced from 41 to 35 mmol/mol (P=0.047). There was no significant change in lipid levels. Testosterone levels and gonadotropins were not routinely remeasured after treatment commenced.

Conclusions: GLP1 agonist use in women with PCOS was associated with significant weight loss, as well as reductions in systolic blood pressure and HbA1C.