Menstrual irregularities, hormonal imbalances and obesity in teenage and adolescent girls in Hyderabad, Sindh, Pakistan

Background: Obesity in young girls adversely affects reproductive health later in life and it is a serious public health issue. The objective was to study the association of obesity with menstrual irregularities and hormonal imbalance in teenage and adolescent girls.

Method: Participants comprised a convenience sample of 12-19 years old girls (N=83). The study was conducted in outpatient clinics at a university hospital. Data were collected through medical history by interview, physical examination and blood tests. Data were analysed using frequencies, descriptive statistics, Chi Squared tests of Independence and Binary Logistic Regression.

Results: The median age was 16 years (mean 15.9, SD 2.2) and the median BMI was 31.14 (mean 32.04, SD 4.51). Most of the girls were obese (95.2%) and some had a family history of obesity (33.7%), diabetes (28.9%) and cardiovascular disease (20.5 %). Clinical presentations included secondary amenorrhea (34.9%), heavy and irregular periods (22.9%) and oligomenorrhea (16.9%). Girls with a polycystic ovary (54.2%, n=45) had a reversed follicle stimulating hormone (FSH) / luteinizing hormone (LH) ratio (OR 11.33, 95% CI 2.98, 43.04, p < 0.001), an upper limit or raised fasting insulin (OR 7.20, 95% CI 2.33, 22.22, p < 0.001), a raised testosterone (OR=5.16, 95% CI 1.56, 17.11, p = 0.007 and a disturbed lipid profile (OR 5.67, 95% CI 1.72, 18.73, p = 0.004). Obesity was not statistically significantly associated with either polycystic ovary syndrome (PCOS) or any of the measured hormone levels.

Conclusion: Adolescent girls presenting with obesity, menstrual irregularities and hormonal imbalance may suggest manifestation of PCOS, which needs early investigation and proper management.

© 2023 The Authors. Published by College of Public Health Sciences, Chulalongkorn University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).