Obesity and menstrual disorders

Best Pract Res Clin Obstet Gynaecol. 2015 May;29(4):516-27. doi: 10.1016/j.bpobgyn.2014.10.010. Epub 2014 Nov 1.


Obese women often present with oligomenorrhoea, amenorrhoea or irregular periods. The association between obesity and heavy menstrual bleeding is not well documented and data on its prevalence are limited. While the investigation protocols should be the same as for women of normal weight, particular focus is required to rule out endometrial hyperplasia in obese women. The treatment modalities of menstrual disorders for obese women will be, in principle, similar to those of normal weight. However, therapeutic outcomes in terms of effectiveness and adverse outcomes need special consideration when dealing with women with a high body mass index (BMI). Here, different treatment strategies are reviewed paying particular attention to the effect of weight on their efficacy and the challenges of providing each treatment option. This chapter aims to review the current literature and address areas where further evidence is needed, which will subsequently influence clinical practice.

Keywords: heavy menstrual bleeding; hormones; menstrual disorders; obesity; surgery.

Publication types

  • Review

MeSH terms

  • Amenorrhea / epidemiology
  • Amenorrhea / metabolism
  • Amenorrhea / therapy
  • Contraceptive Agents, Female / therapeutic use
  • Contraceptives, Oral, Combined / therapeutic use*
  • Endometrial Ablation Techniques*
  • Endometrial Hyperplasia / epidemiology
  • Endometrial Hyperplasia / metabolism
  • Endometrial Hyperplasia / therapy
  • Estrogens / metabolism*
  • Female
  • Humans
  • Hysterectomy
  • Intrauterine Devices, Medicated*
  • Medroxyprogesterone Acetate / therapeutic use*
  • Menorrhagia / epidemiology
  • Menorrhagia / metabolism
  • Menorrhagia / therapy
  • Menstruation Disturbances / epidemiology
  • Menstruation Disturbances / metabolism
  • Menstruation Disturbances / therapy*
  • Obesity / epidemiology
  • Obesity / metabolism*
  • Oligomenorrhea / epidemiology
  • Oligomenorrhea / metabolism
  • Oligomenorrhea / therapy
  • Prevalence
  • Progestins / therapeutic use*


  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • Estrogens
  • Progestins
  • Medroxyprogesterone Acetate