The impact of gastric bypass surgery on sex hormones and menstrual cycles in premenopausal women

Abstract

Obesity has adverse effects on ovulation, menstrual cyclicity and oocyte development leading to clinical symptoms such as infertility and menstrual disorders. The Roux-en-Y gastric bypass (RYGB) leads to weight loss, improved insulin sensitivity and may improve ovarian function. In 31 premenopausal women, 18 eu- and 13 oligo-/amenorrhoic, we followed the changes in follicular phase sex hormones 3, 6 and 12 month after RYGB. The average weight loss during the first postoperative year was 39.6 kg. The insulin sensitivity and serum insulin improved markedly especially within the first three postoperative months. SHBG increased progressively and was doubled after 12 months. In contrast, total and free androgens and DHEA declined about 50% during the first three postoperative months and remained fairly constant hereafter. One year after surgery, 85% (11/13) of the women with oligo-/amenorrhea gained regular menstrual cycles. Our results indicate that some of the endocrine changes related to regulation of ovarian function occur very early after bariatric surgery.

Chinese abstract

肥胖对排卵, 月经周期和卵母细胞发育存在不良影响, 导致不孕和月经失调。 Roux-en-Y胃旁路术(RYGB)可使体重减轻, 改善胰岛素敏感度, 或许可改善卵巢功能。我们随访了31名绝经前妇女 (18名月经周期正常, 13名月经稀发/闭经) RYGB后3,6,12个月的卵泡期性激素变化。术后第一年平均体重降低39.6 kg。胰岛素敏感性和血清胰岛素水平明显升高, 尤其在术后三个月内。SHBG水平逐渐升高, 在第12月时SHBG量是先前的2倍。相比而言, 在术后3个月内, 总雄激素, 游离雄激素以及DHEA降低了50%, 在此之后水平保持稳定。手术1年后, 85% (11/13) 月经稀发/闭经妇女获得了规律的月经周期。我们的结果表明, 一些与卵巢功能调节相关的内分泌变化发生在减肥手术术后的极早期。

Keywords:

• Insulin sensitivity
• menstrual cyclicity
• PCOS
• RYGB
• sex hormones
• weight loss

Acknowledgements

The authors thank the women who participated in the study.

Declaration of interest

The authors reports no declarations of interest.