Wednesday, September 14, 2011

Women's Health: Obesity and Menstrual Irregularities

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Menstrual rregularities are defined as the abnormal menstrual cycle, including Amenorrhea (absence of period), Dysmenorrhea (painful menstrual period), irregular period, spotting, Menorrhagia (heavy period), etc.

D. How Obesity associates with Menstrual Irregularities
1. In the study of 136 adolescent girls from a cohort of 301 girls between 15 and 17 years of age with confirmed menstrual irregularity, with or without ultrasound diagnosed polycystic ovaries, were assessed in detail after a gap of 2 years, conducted by Child Development Centre, Medical College, Thiruvananthapuram, posted in PubMed, researchers concluded that The results of this study support screening for menstrual irregularity, obesity and signs of clinical hyperandrogenism for early diagnosis of PCOS in an effort to improve the reproductive health of adolescent girls.

2. According to the study of "Impact of obesity on gynecology" by Pandey S, Bhattacharya S., posted in PubMed, researchers indicated that Rising obesity rates around the world have had a profound impact on female reproductive health. Childhood obesity is associated with early onset of puberty, menstrual irregularities during adolescence and polycystic ovary syndrome.

3. In a study of Heights, weights (at 7, 11, 16, 23 and 33y) and reproductive data were available for 5799 females in the 1958 British birth cohort study. Body mass index (BMI) was calculated as weight/height2. Age-specific cut-offs were used to define overweight and obesity. Reproductive outcomes reported at age 33 included: menstrual problems (also reported at 16y), hypertension in pregnancy and subfertility, conducted Department of Epidemiology & Biostatistics, Institute of Child Health, posted in PubMed, researchers concluded that Overweight and obesity in early adulthood appears to increase the risk of menstrual problems, hypertension in pregnancy and subfertility. Other than menstrual problems, childhood body mass index had little impact on the reproductive health of women.

4. According of the study of "The relationship between obesity and fecundity" by Yilmaz N, Kilic S, Kanat-Pektas M, Gulerman C, Mollamahmutoglu L., posted in PubMed, researchers concluded that Obesity was found to be associated with reduced fecundity for all weight-adjusted groups of women and persisted for women with regular cycles. Weight loss should be encouraged initially during the treatment of infertile overweight and obese women.

5. In the study of "Obesity and menstrual irregularity: associations with SHBG, testosterone, and insulin" by Wei S, Schmidt MD, Dwyer T, Norman RJ, Venn AJ., posted in PubMed, researchers concluded that both overall and central obesity were significantly associated with having an irregular menstrual cycle. This association was substantially influenced by hormonal factors, particularly insulin and SHBG.

6. Etc.

E. Treatments of Obesity and Menstrual Irregularities
1. In the study of summarizing major factors affecting fertility in obesity, conducted by University Alma Mater Studiorum of Bologna, posted in PubMed, researchers indicated that Fertility can be negatively affected by obesity. In women, early onset of obesity favours the development of menses irregularities, chronic oligo-anovulation and infertility in the adult age. Obesity in women can also increase risk of miscarriages and impair the outcomes of assisted reproductive technologies and pregnancy, when the body mass index exceeds 30 kg/m.

2. According to the study of "Evaluation of irregular menses in perimenarcheal girls: a pilot study" by Browner-Elhanan KJ, Epstein J, Alderman EM., posted in PubMed, researchers found that Those perimenarcheal girls presenting with irregular menses and findings including obesity, acne, or pallor, were likely to have treatable causes of menstrual irregularities. In one of the four girls with a normal physical examination, hormonal testing indicated possible FOH, thus suggesting that hormonal evaluation of perimenarcheal girls with menstrual irregularities may be justified, as it may reveal previously unsuspected pathology.

3. Etc.

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