The Influence of Bariatric Surgery on Reproductive Hormones and Ovarian Morphology and Clinical Findings in Women: A Prospective Study.

BACKGROUND

Obesity in women of reproductive age often causes hormonal imbalances and fertility issues. Bariatric surgery effectively promotes weight loss and metabolic improvement, but its impact on reproductive hormones warrants further investigation. This study examines bariatric surgery's effects on hormonal and clinical changes in women preoperatively and at 3 and 6 months postoperatively.

METHODS

This prospective study included 67 women undergoing bariatric surgery. Anthropometric measurements, hormonal profiles, ovarian morphology(via ultrasonography), and the presence of hirsutism and dysmenorrhoea were evaluated preoperatively and at 3- and 6-month follow-ups.

RESULTS

Bariatric surgery resulted in significant weight loss and hormonal changes. Body weight (p < 0.001) and BMI (p < 0.001) decreased substantially, with the most rapid reduction occurring in the first 3 months, followed by a slower decline. Androstenedione levels decreased significantly (p < 0.001). Total testosterone levels showed a significant reduction at 6 months (p < 0.001), while SHBG (p < 0.001; p = 0.014), DHEA-S, and AMH (p < 0.001; p < 0.001; p = 0.014) levels increased. No significant changes were observed in FSH and LH levels (p > 0.05). The severity of dysmenorrhea decreased significantly at 6 months (p < 0.001). Additionally, the prevalence of hirsutism (p < 0.001) and polycystic ovary (PCO) morphology (p < 0.001) decreased significantly at 6 months.

CONCLUSIONS

Bariatric surgery significantly decreases testosterone and androstenedione, while increasing AMH, DHEA-S, and SHBG. Improvements in PCO morphology, dysmenorrhea, and hirsutism highlight the effects of bariatric surgery on hormonal balance and reproductive health.