Obesity and heavy periods: What to know

We hear expert insight on the connection between obesity and heavy menstrual periods in this informative article by highly respected London-based women’s health expert and consultant gynaecologist Mr Mahantesh Karoshi. The leading specialist details the various obesity-related factors which can affect menstrual flow and also sheds light on how heavy periods can be managed and treated.

What is the connection between obesity and heavy periods?

Heavy periods, also known as menorrhagia, is a common women’s health condition that can significantly impact a woman's quality of life. Evidence suggests that obesity is a significant risk factor for heavy periods, and several mechanisms, including:

• hormonal imbalances,
• lining of the womb dysfunction, and
• chronic inflammation, may contribute to the development of heavy periods in obese individuals.

Heavy periods are known to cause significant physical, emotional, and social distress.

Obesity, defined as an excessive accumulation of body fat, has been identified as a potential risk factor for heavy periods. Understanding the relationship between obesity and heavy periods is crucial for effective management and treatment of this common menstrual disorder.

Imbalance of hormones

Obesity is associated with alterations in hormonal balance, particularly an increase in circulating oestrogen levels. Adipose tissue (body fat tissue) produces oestrogen, and excess adiposity leads to elevated oestrogen production. Oestrogen is known to promote endometrial growth (lining of the womb growth) and vascularity, potentially contributing to heavy periods. Additionally, oestrogen can disrupt the delicate balance between oestrogen and progesterone, leading to anovulatory cycles (absent ovulation or missed ovulations) and irregular shedding of the endometrial lining.

Dysfunction of lining of the womb

Obese individuals often exhibit structural and functional abnormalities in the lining of the womb. Increased body fat can induce chronic low-grade inflammation and oxidative stress, leading to lining of the womb dysfunction and this can cause blood vessels in the uterus to develop in an irregular and excessive manner, which can also contribute to heavier and prolonged menstrual bleeding.

Chronic Inflammation

Obesity is characterised by a state of chronic low-grade inflammation. Chronic inflammation in obesity may lead to vascular abnormalities, impaired clotting of blood, and altered platelet function, all of which can contribute to heavy periods.

Other contributing factors

• Obesity is often associated with comorbidities such as polycystic ovary syndrome (PCOS) and insulin resistance.
• These conditions are also independently linked to heavy periods and may further exacerbate menstrual irregularities and heavy bleeding in obese individuals.
• Moreover, fatty tissue (adipose tissue) is involved in the production and metabolism of various hormones and factors that play a role in the regulation of menstrual bleeding, such as leptin and adiponectin.

Management and treatment

Managing heavy periods in obese individuals requires a multifaceted approach. Lifestyle modifications aimed at weight reduction can help restore hormonal balance and improve menstrual regularity.

Pharmacological interventions, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies (e.g., combined oral contraceptives), may also be effective in managing heavy bleeding in obese women.

Key points to take away

Obesity is strongly associated with heavy periods, and multiple mechanisms are believed to contribute to this relationship. Hormonal imbalances, endometrial dysfunction, and chronic inflammation are among the key factors involved.

Understanding the impact of obesity on heavy periods is crucial for developing effective prevention strategies, early detection, and targeted treatment approaches that address both obesity and menstrual health. Further research is needed to elucidate the intricate mechanisms underlying this relationship and explore novel therapeutic interventions.



To schedule a consultation with Mr Karoshi, visit his Top Doctors profile today.