Comparison of the effects of laparoscopic sleeve gastrectomy and endoscopic intragastric balloon placement on hormone profile and menstrual cycle in obese women with polycystic ovary syndrome.

Abstract

Background and aim: Obesity is a significant public health problem with increasing prevalence worldwide, and polycystic ovary syndrome (PCOS) is a common comorbidity in obese women. PCOS is characterized by hormonal imbalances, menstrual irregularities, infertility, and metabolic disorders. Weight management is critical in obese women with PCOS to improve both reproductive health and achieve metabolic and hormonal balance. To this end, surgical treatments have come to the forefront, and procedures such as laparoscopic sleeve gastrectomy (LSG) and endoscopic intragastric balloon (EIB) placement are being used increasingly.

Methods and results: This is a retrospective study conducted at [Blinded for review] between January 2022 and October 2024. It compares the effects of laparoscopic sleeve gastrectomy and endoscopic intragastric balloon placement in female patients aged 18-40 who were diagnosed with PCOS and obesity. In the study, anthropometric measurements, hormonal parameters, and menstrual cycles were evaluated before treatment and 6 months after treatment and analyzed between the two groups. There was no difference in age between patients who underwent laparoscopic sleeve gastrectomy and endoscopic intragastric balloon placement (p = 0.424). The preoperative BMI and the difference between preoperative and postoperative BMI were higher in the LSG group (p < 0.001), but the postoperative BMI values were similar between the two groups (p = 0.583). The waist/hip ratio was higher in the LSG group (p < 0.001, p = 0.010, p < 0.001). While both surgeries showed a reduction in free androgen index and AMH, this reduction was not statistically significant (p > 0.05), both surgeries increased SHBG (p > 0.05). The decrease in AMH was greater in the LSG group (p = 0.020). Total testosterone decreased in the sleeve gastrectomy group (p < 0.001) and the menstrual cycle improved (p = 0.035).

Conclusion: In summary, both laparoscopic sleeve gastrectomy and endoscopic intragastric balloon placement led to positive changes in hormone profiles and menstrual cycle characteristics. However, LSG was found to be more effective on these parameters.