**1. Introduction**

Polycystic ovary syndrome (PCOS) is considered to be the most common endocrinopathy affecting women with an incidence ranging from 5 to 13% [1], depending on the diagnostic criteria applied.

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Polycystic ovary syndrome—in spite of many years of research—is still a controversial topic. We have come to know in detail its clinical manifestations such as metabolic disorders, menstrual and ovulatory dysfunctions, and clinical hyperandrogenism. However, not knowing its etiology, most of the treatments suggested to patients with PCOS are symptomatic, not addressing to the underlying cause, but rather each symptom in part.

by its association with the metabolic syndrome, it is still a topic of debate [10]. Studies demonstrate that in patients with PCOS, even if the criteria for the metabolic syndrome are not fully

Lifestyle Changes and Weight Loss: Effects in PCOS http://dx.doi.org/10.5772/intechopen.73298 41

The research in the field demonstrates the presence of the risk factors for the metabolic syndrome in women with PCOS. Of these, the following appear to be important: the level of fasting insulin (which in these patients is doubled [12]) and obesity (an independent risk factor

Impaired glucose tolerance (IGT) or even type 2 diabetes mellitus (T2DM) are common in patients with PCOS with a prevalence rate of 30–40% for impaired glucose tolerance and 7.5–10% for type 2 diabetes mellitus [13, 14]. The risk of patients with PCOS to develop these pathologies is considerably higher than in healthy patients. In these cases as well obesity appears to play an important role–impaired glucose tolerance and diabetes mellitus have an increased prevalence in obese patients (31.3% IGT and 7.5% T2DM) in comparison to non-

It is not known exactly to what extent PCOS would be an independent risk factor for cardiovascular diseases but, unquestionably, through associated pathologies (obesity, increased resistance to insulin, IGT, T2DM, and/or dyslipidemia), it contributes to an increased risk [15].

Most experts consider that hyperandrogenism is the main characteristic of PCOS [16], whether is biochemically or clinically identified. Alteration in insulin action as well as enzy-

Studies suggest that the androgenic hyper-responsiveness that characterizes women with PCOS is probably due to the factors controlled by insulin sensitization rather than luteinizing hormone (LH), adrenocorticotropin hormone (ACTH), or ovarian steroids *per se* [16]. Multiple molecular and cellular pathways seem to be involved in the production of androgenic hormones, most of them involving ovarian theca cells, insulin receptors, Cytochrome P450 17α-monooxygenase (P450c17) activity as well as components of mitogen-activated protein

The clinical correspondence of this intricate biochemical processes have incredible impact on patients' quality of life and psychological status. Virilising signs and symptoms, acne and

Obesity is a key metabolic entity in some PCOS patients. Because of its undeniable influence on insulin resistance, it has become a target to treat when identified. PCOS women, who are obese tend to have higher hirsutism and acne scores than their lean counterparts [16]. The consequent importance of weight loss is therefore essential to be taken into account. It is

hirsutism are most often the first elements to lead to the clinical suspicion of PCOS.

**2.2. Improvement of hyperandrogenic symptoms (hirsutism, acne, scalp hair loss)**

met, there is at least one component of the metabolic syndrome [11].

obese patients (10.3% IGT and 1.5% T2DM) suffering from PCOS.

matic defaults has been discussed as possible pathogenic theories.

*2.1.4. Impaired glucose tolerance or type 2 diabetes mellitus*

for the metabolic syndrome).

*2.1.5. Cardiovascular disease*

kinase (MAPK) insulin pathway.

Following numerous studies and research on PCOS and despite that the exact mechanism is not completely understood, the conclusions of most researchers are the same; lifestyle change and weight loss have beneficial effects on the entire panel of symptoms associated with this syndrome.
