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9 - Lifestyle factors in the etiology and management of polycystic ovary syndrome

Published online by Cambridge University Press:  29 September 2009

By
Robert Norman  and
Lisa Moran
Edited by
Gabor T. Kovacs  and
Robert Norman
Robert Norman
Affiliation:
The University of Adelaide
Lisa Moran
Affiliation:
CSIRO Human Nutrition, Australia
Gabor T. Kovacs
Affiliation:
Monash University, Victoria
Robert Norman
Affiliation:
University of Adelaide
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Summary

Introduction

Polycystic ovary syndrome (PCOS) is thought to arise from a combination of familial and environmental factors that interact to cause the characteristic menstrual and metabolic disturbances. It is our contention that alteration of the environmental components of this condition is fundamental to the management of the condition and that pharmaceutical treatment (including clomiphene citrate, gonadotropins, and insulin sensitizing agents) should only be used after adequate counseling and action relating to lifestyle alterations. Attention to weight loss, altered diet, and exercise are important aspects to discuss with the patient as well as stopping smoking and improving psychological attitudes. Because of the importance of overweight in the majority of women with this condition, much of this chapter will concentrate on obesity in PCOS.

Obesity and disease

Obesity is a costly and increasingly prevalent condition in Western society. In the USA 50% of Americans are overweight with women (34%), blacks (49%), and Hispanics (47%) showing the highest rates of obesity. In Australia 40% of the population are overweight or obese according to recent Australian Bureau of Statistics data. The prevalence of overweight/obesity increases in Australian women as they age with 34% of all women between 20–69 years having a body mass index (BMI) (weight in kg/height in m2) over 25 and 12% with a BMI over 30. In the Repromed Centre at the University of Adelaide, 40% of women have BMI over 25 and 20% a BMI over 30 based on over 5000 patients presenting between 1991 and 1997.

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Polycystic Ovary Syndrome , pp. 121 - 139
Publisher: Cambridge University Press
Print publication year: 2007

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