Overview

Obesity and menstruation irregularities often coexist in women with excess weight. Menstrual irregularities can present in various forms and the extra pounds can even interfere with conception making it more difficult for an obese woman to conceive.

Obesity is excess fat in a person’s body with a BMI of 30 kg/m2 or more. It is the excess fat around the abdomen (central obesity) that is dangerous to health and not the subcutaneous fat around the hips and the thighs. That is why abdominal circumference is also essential when weighing the health risks of an obese person.

Besides these obesity health risks such as heart disease, hypertension, diabetes, and sleep apnea in men, obese women of reproductive age expose themselves to an additional complication of menstrual irregularities. These irregularities may pertain to menstrual bleeding and/or the menstrual cycle.

Besides menstrual cycle disturbances, being obese can significantly reduce your chances of conception and pregnancy.

Women with severe central obesity are three times more prone to menstruation irregularities than women with a healthy weight.

The risk of menstrual disorders is double in women with a BMI of 24–25 (overweight women) and fivefold higher in those with a BMI of 35 or more (morbidly obese women).

The menstrual irregularities can be in the form of variations in the length of the menstrual cycle, the regularity of the periods, and the amount of menstrual bleeding.

Even a 20% increase in body weight can cause amenorrhea (absence of period). Incidentally, even weight loss has been shown to influence menstrual cycle regularity.

The menstrual cycle can be normal, short, or irregular.

  • Normal menstrual cycle. The length of the menstrual cycle varies among women but in most, the normal cycle lasts anywhere between 26 to 34 days.
  • Short cycle. Short cycles are those that last for less than 25 days, while long cycles are those that last for 35 days or more.
  • Irregular cycle. Irregular cycles are those when there is more than 15 days’ difference between the longest and the shortest cycle during the past year.

What types of menstrual problems can occur in obese women?

Obese women have been found to have irregular menstrual cycles with increased incidences of oligomenorrhea or amenorrhea. Obesity also predisposes to irregularities in ovulation and higher rates of miscarriages.

Among obese adolescents, menstrual cycle irregularity and the development of polycystic ovary syndrome (PCOS), can result in infrequent or absent menstrual periods, and heavy menstrual bleeding.

Obese women can have the following menstrual problems.

  • Amenorrhea (absence of periods)
  • Oligomenorrhoea (light or infrequent menstrual periods)
  • Dysmenorrhea (heavy and painful periods)
  • Prolonged bleeding that can last for weeks
  • Unpredictable irregular periods (early or late periods)

Why obesity disturbs the menstrual cycle and menstruation?

The main cause of menstrual disturbances in obese women is hormones. Your hormones control your menstrual cycle. Estrogen is one such important hormone.

Besides other functions, estrogen is responsible for the development of the inner uterine lining during each menstrual cycle. This is done to facilitate the implantation of the fertilized ovum.

However, if the ovum is not fertilized during that particular cycle, the thickened uterine lining (called the endometrium) is shed off during the menstrual period.

When you are overweight or obese, you build up fat cells that produce estrone, which is a form of the estrogen hormone.

More fat cells mean more amount of estrogen, which translates into a thickened endometrium.

You, therefore, will then bleed more during menstruation and this can go on for a prolonged period.

Excess amounts of fat cells produce an excess amount of estrone. This can interrupt the normal secretion of other menstrual hormones, causing infrequent periods.

The excess estrogen can affect how often you have periods, and can also cause your periods to stop.

Fat cells produce estrogen and therefore obese women have higher estrogen levels as happens during pregnancy. High estrogen levels produce the effect of pregnancy though pregnancy does not exist. Ovaries, therefore, stop ovulating, and menstruation stops. That is why obese women have amenorrhea or no periods.

Other causes for menstrual disturbances in obesity

Insulin resistance most commonly seen in obesity causes polycystic ovarian syndrome in which again periods remain absent.

Poor nutrition in obesity is also seen due to the fact that obese women eat high-calorie foods that may not be nutritious. Poor nutrition is a cause of anemia, which is responsible for scanty or no periods.

A lower level of vitamin D is often present in obese women because of the absence of outdoor activity and consequent insufficient sunlight exposure.

Again, poor nutrition status due to the intake of the wrong foods contributes to Vitamin D deficiency, which was associated with 13.3 times the odds of having an irregular cycle. Several studies have found that patients with PCOS are vitamin D deficient

How to set it right?

The association between obesity and menstruation problems can be set right by losing weight with some DIY steps. Losing even five percent of your body fat can regularize your menstrual cycle and facilitate pregnancy.

The reason for this is that fewer fat cells mean fewer amounts of excess hormones, which is the reason for menstrual irregularities.

Weight loss also improves ovulatory function and PCOS symptoms in affected individuals.

The reasons explained above aptly demonstrate that losing weight in an appropriate fashion will greatly influence setting your menstrual irregularities right.

You should, therefore,