FRIDAY, May 11 (HealthDay News) -- Obese women often stop
getting their periods, but new research suggests weight-loss
surgery can help regulate their monthly cycles, while also stemming
excessive hair growth and skin problems that often accompany
significant weight gain.
"Obesity is a huge problem in the United States," said study author Chandhana Paka, a fellow in minimally invasive gynecological surgery at Stanford University School of Medicine. "We wanted to see if bariatric surgery [weight-loss surgery] was a solution to helping restore menstruation in morbidly obese women whose periods have become irregular or disappeared."
She said hormonal changes that occur when women reach a high
body-mass index (BMI) -- production of more male hormones, for
example -- can lead to menstrual disturbances. BMI is a calculation
based on weight and height.
Paka, who was a resident at St. Luke's-Roosevelt Hospital Center
in New York City when she conducted the study in 2008 and 2009, and
her colleagues were scheduled to present their research this week
at the annual meeting of the American College of Obstetricians and
Gynecologists, in San Diego.
For the study, the scientists monitored 126 women planning to
undergo bariatric surgery, which involves reducing stomach size to
help patients cut back on food intake in order to reach a healthy
The women were between 18 and 49 years old, and not yet in
perimenopause, the time approaching menopause. Their average age
was 39, Paka said.
The average BMI of the study participants was 46, well over the
normal range of about 18 to 24, said Paka. Prior to surgery, 52
percent said they had regular periods; 39 percent reported
irregular periods and 22 percent reported no periods.
Twelve months after surgery, Paka said, the average BMI was down
to 33, and 99 percent who had previously reported irregular menses
had started having regular periods again. Close to 82 percent of
previously amenorrheic women (those having no periods at all) had
started having regular menses, too.
"We saw women who within a month after surgery were having their periods again. The majority of obese women who had irregular or no menstruation before surgery reported regular monthly periods after surgery," said Paka. "We were surprised to see how fast that can happen."
She said many also experienced a reduction in excess hair
growth, hair loss (alopecia), acne, and a skin condition called
acanthosis nigricans -- a darkening that can appear in the folds of
the skin, around the neck and underarms, for example.
Dr. Thomas Price, an associate professor of reproductive
endocrinology and fertility at Duke University Medical Center in
Durham, N.C., said the findings aren't surprising.
"All of the results are easily explainable by the hormone changes associated with weight loss," he said. He explained that as weight loss occurs, hormonal balance improves.
Price said the study doesn't touch on the other health problems
associated with a high BMI. "It doesn't get into the increase in
hypertension that goes along with obesity, the increase in
arthritis because of trauma to the joints, the increase in sleep
apnea that can lead to hypertension and heart disease. The risk for
endometrial cancer goes up. There's no joking around with the risks
associated with obesity," he said.
"There is not a downside to weight loss through bariatric surgery," Price added, but he noted that women wishing to get pregnant should discuss how long to wait post-surgery before trying to conceive. Sometimes a year's wait is recommended, he said. He also said health insurance doesn't always cover the procedure.
Paka pointed out that bariatric surgery is not necessarily a
solution for overweight women with fertility issues, but it's one
avenue women can discuss with their obstetricians. Diet and
exercise are always an ideal approach to weight reduction, Paka
She said an obstetrician/gynecologist is often the only
physician a woman sees regularly, and preventive care -- which
includes helping patients reach a healthy weight -- needs to be
tackled by the OB/GYN.
"If the gynecologist is the gatekeeper of a woman's health, that means it's our responsibility to say, 'Hey, you're having some problems with your weight. Are you exercising enough? Are you eating well?' said Paka. But sometimes so many illnesses are occurring at the same time, she added, "that though I don't think it should be what we run to, bariatric surgery is an option that needs to be available."
Data and conclusions presented at meetings should be considered
preliminary until published in a peer-reviewed medical journal.
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