The menstrual cycle is a term that refers to the period of time from the first day of one menstruation to the day preceding the next. The menstrual cycle consists of three phases: the follicular phase, which begins on the first day of menstruation; ovulation; and the luteal phase, which precedes the onset of the next menstruation. Its characteristics can change under the influence of various factors, among which body weight fluctuations play a very important role.
Why can obesity change the menstrual cycle?
Obesity is a condition characterized by abnormal accumulation of fat in the body, which can have significant consequences for health and quality of life. It is also defined by a body mass index (BMI) of 30 or higher. Women with obesity often experience reproductive problems that manifest in different ways, from irregular menstruation to polycystic ovary syndrome (PCOS) and reduced fertility.
The reason for these disorders lies in the fact that metabolic and hormonal changes in women with obesity are extremely complex and often interconnected. The age at which obesity begins plays a fundamental role. If it develops in an adolescent girl, the risk of menstrual cycle disorders increases later in life as well.
What menstrual cycle problems are associated with obesity?
There are various causes of menstrual cycle disorders, including obesity, although it is clearly not the only one. Hormonal changes, endocrine diseases such as thyroid disorders, mental health conditions, chronic psychophysical stress, very intense and prolonged physical activity, rapid weight loss, chronic illnesses, and the use of certain medications can also contribute.
In particular, problems associated with obesity include amenorrhea, oligomenorrhea, and irregular menstruation, sometimes with very heavy and exhausting bleeding to the point that it interferes with normal daily activities. Although the mechanisms triggering these phenomena are not yet fully understood, a key role is thought to be played by the presence in women with severe excess weight of hyperandrogenism, or excessive production of male hormones, especially testosterone, and hyperinsulinemia, or excess insulin in the blood. These conditions are almost always associated with insulin resistance, a state very common in patients with obesity and in those who develop polycystic ovary syndrome.
Parameters of the menstrual cycle
To determine whether a cycle is regular or irregular, four parameters are considered: rhythm, amount, duration, and the nature of the discharge.
Rhythm disorders: the main ones in this respect are amenorrhea, polymenorrhea, and oligomenorrhea. Amenorrhea is the complete absence of menstruation for at least three consecutive months during the reproductive period in the absence of pregnancy or breastfeeding. Polymenorrhea is an interval between menstruations of less than 25 days. Oligomenorrhea is an interval between menstruations of more than 35 days.
Abnormalities in the amount and duration of menstruation
Menstruation is considered regular by this parameter if it lasts from 3 to 7 days and the intensity of bleeding gradually decreases each day. Hypomenorrhea refers to lighter-than-usual menstrual bleeding. Hypermenorrhea refers to heavier-than-usual menstrual bleeding. Menorrhagia is significantly heavier-than-normal menstrual bleeding, exceeding 80 ml and lasting more than 7 days.
Metrorrhagia is abnormal bleeding, light or heavy, that occurs independently of menstrual bleeding or during periods of life when it should not occur, such as puberty, pregnancy, or postmenopause.
What should be done?
If menstrual cycle disorders are caused by obesity or related problems, specialists at the Bogolyuby Medical Center emphasize that the first step in treatment is correcting the patient’s lifestyle and diet. This process should be developed together with a physician and carried out under continuous supervision, and only after other possible causes have been carefully ruled out.
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