[Hormonal abnormalities were improved by weight loss using very low calorie diet in a patient with polycystic ovary syndrome].

A 27-year old woman was admitted to our hospital because of oligomenorrhea, hirsutism and obesity. Her menstrual period has been irregular since she was 14 years old. Her weight increased rapidly after the age of 15 and she became obese. Hirsutism was noticed at the age of 16. The diagnosis of polycystic ovary syndrome was made on her illness through the endocrinological examinations: (1) The response of LH to LH-RH administration was much higher than that of FSH. (2) The concentration of plasma testosterone was increased. (3) Plasma level of E2 was decreased while that of E1 was increased. (4) CT scan showed bilateral ovarian cyctic masses. In addition, hyperinsulinemia was observed during the 75g glucose tolerance test and the presence of insulin resistance was suggested. As she was overweight (BMI; 33.6 kg/m2), weight loss was expected to improve her hormonal abnormalities. She went on a very low calorie diet of 420 kcal/day (Optifast, Sandoz, USA). When she lost around 9kg of weight, her menstruation period started that has not been observed for the previous 5 months. Plasma levels of LH, FSH and testosterone were lowered following the weight loss. The responses of LH to LH-RH and IRI to glucose were decreased as well. She left the hospital after the second menstruation occurred at the proper period. From these results, the importance of weight loss was suggested in overweight patients with polycystic ovary syndrome. The benefit of very low calorie diet was also noticed since it brought a rapid weight loss as well as rapid improvements of hormonal abnormalities.