In the United States , the fastest growing health threat is not heart disease, cancer or HIV/AIDS, but obesity. This all-too-common problem has become epidemic across the country, affecting pre-school-age children on up to middle-aged adults and even seniors. Turn on the television and you will see myriad ads boasting newer (and usually, much easier ) means for losing weight. As Americans, we are also bombarded by the adverse effects of weight on our health, including increased risk for heart attack, stroke and diabetes, but women are rarely made aware of the effects of obesity on their reproductive system.
Many times, a woman will visit her gynecologist for irregular periods. This may be dismissed as a result of stress if other tests are normal, but it cannot be overlooked that obesity may play a significant part in this problem for many women.
The mechanism behind increased weight and irregular menstrual cycles is related to disruptions in the normal hormonal control that determines the timing of a woman's period. An increase in body fat percentage also increases circulating estrogen levels in the body. This excess estrogen causes conflicting signals to the ovaries and to the brain, which results in irregular or absent egg release (ovulation) from the ovaries. When ovulation is late or absent, abnormal cycles result.
The abnormal cycles can be especially heavy, causing many women to lose excess iron, and on rare occasions, even requiring hospitalization for treatment of severe blood loss. For less severe bleeding, patients may just require iron therapy, but certain women may require blood transfusion to prevent more serious complications.
For women who desire pregnancy, the effects of obesity on the menstrual cycle can be frustrating as well, since a large percentage of infertile couples suffer from ovulatory dysfunction. Women with this problem are often treated with medications to improve ovarian function. These medications can have serious side effects that may not be tolerated well by patients.
One of the most serious side effects of obesity on the menstrual cycle involves the increased risk of cancer in women with high circulating levels of estrogen. This estrogen can trigger uncontrolled and irregular growth of the lining of the uterus which can even degenerate into uterine cancer, the most common cancer of the genital tract in women.
Irregular cycles caused by obesity are often treated with hormonal medications, but the treatment should always include a weight-loss program. Even modest weight loss, sometimes just 5-10 pounds may result in improvement of the menstrual cycle in some women. The decrease in percentage of body fat can improve the hormone balance between the brain and the ovaries, resulting in more regular ovulation and more normal cycles.
Women who are overweight or obese and who have irregular cycles should visit their gynecologist to discuss the problem and develop a plan for evaluation and treatment of their condition. Not only can the gynecologist rule out more significant problems, but together the patient and her physician can come up with a healthy regimen of diet and exercise to combat this problem.
