Improving menstrual function through weight loss

This study examined whether weight loss through diet or exercise affected production of antimüllerian hormone and menstrual function in overweight polycystic ovarian syndrome patients.

Polycystic ovarian syndrome can present with a variety of symptoms, including multiple cysts on the ovaries (immature eggs, or follicles), abnormal hormone levels (such as high testosterone), infrequent or absent ovulation and menstruation, obesity, and insulin resistance. Women with polycystic ovarian syndrome often struggle with infertility, and are at higher risk of type 2 diabetes mellitus and cardiovascular disease. Therefore, weight loss is an important part of treatment. 

Antimüllerian hormone is produced by developing follicles in the ovaries, and is often elevated in women with polycystic ovarian syndrome. It is thought that antimüllerian hormone levels correlate with the level of ovarian dysfunction. It is unclear, however, whether weight loss affects antimüllerian hormone levels or whether decreasing antimüllerian hormone leads to a decrease in symptom severity. The current study examined the effects of weight loss through diet and exercise programs on antimüllerian hormone levels and symptoms in polycystic ovarian syndrome patients.

In this study, 43 patients were randomly assigned to one of three lifestyle interventions: diet changes, exercise programs, or a combination of the two. The programs were followed for four months, and women were further followed for up to a year. At the start of the study, after the four months of lifestyle interventions, and at 1 year women were given a general health check (weight, blood pressure, and body mass index measurements), and hormone levels, including antimüllerian hormone and testosterone, were measured.

Only the women in the diet group saw significant decreases in antimüllerian hormone levels, from 74 pmol/L at the start of the study to 55 pmol/L after the intervention. The exercise only and combination groups did not see significant decreases in antimüllerian hormone. 

Antimüllerian hormone levels were found to correlate with menstrual dysfunction: antimüllerian hormone levels prior to treatment were higher in women who did not menstruate than in women who had infrequent menstruation, and were lowest in women with normal menstrual patterns. Decreased antimüllerian hormone led to significant improvement in menstrual dysfunction.

A decrease in antimüllerian hormone also correlated with a decrease in other hormone levels, particularly testosterone. A decrease in body mass index, however, was not associated with decreased antimüllerian hormone levels.

The current study concluded that antimüllerian hormone is associated with both testosterone levels and menstrual dysfunction, and can be reduced through improved diet. 

There were limited numbers of patients in each treatment groups.