The influence of obesity on the onset of puberty and the menstrual cycle

Obesity is not a new phenomenon, however the obesity epidemic in the last few decades - with further acceleration in the time of Covid 19 - is caused not only by genetic factors, but also by lifestyle and environment (nutrition, physical activity, perinatal programming). Obesity usually leads to insulin resistance, when cells cannot respond sufficiently to the action of insulin, which leads to its overproduction, to hyperinsulinemia. Increased insulin levels stimulate the ovaries to overproduce androgens, and androgens can further wor­sen insulin resistance and increase blood insulin levels. This creates a vicious circle where hyperinsulinemia and hyperandrogenism reinforce each other. Typical other medical complications include diabetes, hypertension, hyperlipidemia, and metabolic syndrome. In adolescent girls, obesity can also cause an earlier onset of puberty and menarche. The consequence of hyperandrogenism is irregular bleeding or missing menses, as well as polycystic ovary syndrome and a higher incidence of dysmenorrhoea and premenstrual syndrome.

Keywords: obesity, menstrual cycle, hyperandrogenism, hypermenorrhoea, polycystic ovary, hypothalamus - pituitary - ovary axis.