PCOS and the Ghrelin Miscue – A Symphony of Challenges and Potential Solutions

January 9, 2024by Dr. S. F. Czar0

Case Study:

Patient: Sarah J., a 32-year-old woman diagnosed with PCOS at age 25.

Presenting Complaints:

  • Irregular menstrual cycles (every 3-4 months)
  • Excessive hair growth on face and chest
  • Acne
  • Obesity (BMI 32)
  • Difficulty losing weight despite dietary changes
  • Increased appetite and cravings

Medical History:

  • No prior pregnancies
  • Family history of type 2 diabetes

Laboratory Findings:

  • Elevated androgen levels (testosterone)
  • Insulin resistance
  • Normal thyroid function


Polycystic ovary syndrome (PCOS) with insulin resistance and suspected ghrelin dysregulation.


  • Managing multiple symptoms and their complex interplay.
  • Addressing both hormonal imbalances and metabolic dysfunction.
  • Overcoming difficulties with weight management and appetite control.
  • Potential for developing comorbidities like type 2 diabetes and cardiovascular disease.

Treatment Plan:

  • Medications:
    • Metformin to improve insulin sensitivity.
    • Spironolactone to manage androgen excess and hirsutism.
    • Consideration of ghrelin receptor antagonists if appetite control remains a significant challenge.
  • Lifestyle Modifications:
    • Healthy diet with focus on low-glycemic index foods and portion control.
    • Regular physical activity to promote weight loss and improve insulin sensitivity.
    • Stress management techniques to address potential emotional eating triggers.
  • Behavioral Interventions:
    • Cognitive-behavioral therapy (CBT) to develop healthy coping mechanisms for cravings and emotional eating.
    • Mindfulness practices to promote body awareness and intuitive eating.


With a comprehensive treatment plan addressing both hormonal and behavioral factors, Sarah has the potential to improve her symptoms, manage her weight, and reduce her risk of long-term complications. Regular monitoring and adjustments to the treatment plan will be crucial as she progresses.

Key Learnings:

  • PCOS is a complex hormonal disorder with diverse impacts on metabolism, appetite, and overall well-being.
  • Ghrelin dysregulation may play a role in the appetite and weight management challenges faced by women with PCOS.
  • A holistic approach combining medical interventions, lifestyle modifications, and behavioral therapy is essential for effective PCOS management.
  • Early diagnosis and proactive management can significantly improve the quality of life and long-term health outcomes for women with PCOS.
  • https://drzaar.com/unraveling-estrones-influence-in-pcos/

Leave a Reply

Your email address will not be published. Required fields are marked *

© 2023. All rights reserved.