The clinical value of a longterm three-component lifestyle intervention in women with PCOS

Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is associated with overweight and obesity. In turn, excess weight worsens the clinical presentation of PCOS. We designed a randomized controlled one-year three-component lifestyle intervention (LSI), with or without additional short message service (SMS+ or SMS-, respectively), to lose weight by aiming at changing cognitions, changing dietary habits, and encouraging and promoting physical activity. The control group comprised care as usual, which consisted of an advice to lose weight by methods of their own choosing. The general aim of this thesis was to determine whether this LSI, with or without SMS, had an effect on the clinical manifestations of PCOS in overweight and obese women who also had a wish to become pregnant. We found that the amount of weight loss was positively associated with the intensity of the program. All groups demonstrated improvements regarding PCOS characteristics, although these were more profound within the LSI groups. We also found that this lifestyle intervention was more successful in improving physical activity and metabolic health compared to usual care, and observed positive effects on mood and eating behaviour. In the end, we found no significant differences in conception resulting in live birth rates between the groups. Nonetheless, a large proportion of all participants eventually conceived spontaneously, and after LSI the number of uneventful pregnancies was higher compared to care as usual.