Menstrual dysfunction in adolescent girls who are overweight: a literature review

Abstract

This study aimed to review the modern literature on the problems of adolescent obesity and the pathogenesis of menstrual dysfunction in overweight adolescents and women of reproductive age. In recent years, a large number of works have been published on the relationship of hyperinsulinemia with ovarian hyperandrogenism. Most authors recognize that insulin resistance and hyperinsulinemia contribute to polycystic ovary syndrome formation. The formation of menstrual disorders in overweight girls is based on the violation of gonadotropin secretion, insulin resistance, and hyperinsulinemia, which over time lead to hyperandrogenism. A decreased level of somatotropic hormone and insulin-like growth factor and an increased level of leptin leads to malfunctions in the correct functioning of the hypothalamic-pituitary system. These changes disturb the ovulatory function and, consequently, adolescent reproductive health. The relationship between obesity and depression is actively discussed by foreign authors, and the obtained results often contradict each other. Most studies suggest that excessive weight gain during adolescence can lead to depression, negative mood, and low self-esteem. This study analyzes the results of research by domestic and foreign authors on the issues of diagnosis and treatment. Menstrual disorder therapy against the background of overweight adolescent girls is a matter of dispute among clinicians. With weight loss in adolescents, a significant improvement is found in carbohydrate and lipid metabolism, decreased levels of hepatic transaminases, and a decreased severity of obstructive sleep apnea syndrome.