Can hypothalamic obesity and PCOS cause weight gain?

Question

Hello Doctor,

I am a 29-year-old woman struggling with weight gain that began after a head injury a few years ago. My doctors now suspect hypothalamic obesity. Despite eating a healthy diet and exercising regularly, I continue to gain weight. My menstrual cycles have also become irregular. How is hypothalamic obesity typically managed in women, particularly in those concerned with fertility and hormonal balance?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your signs and symptoms, your condition may be related to hypothalamic obesity as well as polycystic ovary syndrome (PCOS). The diagnosis of PCOS is typically made using the Rotterdam criteria. According to these criteria, a diagnosis is established when at least two of the following three features are present:

Polycystic ovaries on pelvic ultrasound are defined as either 12 or more follicles in each ovary or an ovarian volume greater than 10 cubic centimeters (cm³); oligo-ovulation or anovulation, meaning infrequent or absent menstrual cycles; and clinical and or biochemical signs of hyperandrogenism, such as unexplained weight gain, acne, or excessive hair growth (hirsutism).

To further evaluate your condition, I recommend the following investigations:

Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
On the second day of your menstrual cycle, serum prolactin, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and a pelvic ultrasound.

For management, it is advisable to consult a registered dietitian to develop a personalized dietary plan and to maintain regular physical activity. In terms of medical treatment, I suggest starting a combined oral contraceptive containing Ethinylestradiol and Drospirenone (Yasmin). Take one tablet daily, beginning on the second day of your menstrual period, for 21 consecutive days, followed by a seven-day pill-free interval. This cycle should be repeated for a total of three months, or as advised by your healthcare provider.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.