Obesity is a problem of enormous proportions worldwide. Obesity has significant and far reaching implications on gynaecological health at all stages of a woman’s life.
Adolescent Health:
The age of menarche is determined by various factors one of which is nutrition. The age of onset of puberty has been found to be reducing over the years due to changes in lifestyle and eating habits. Obesity also has been found to play a significant role in young girls who develop irregular periods and polycystic ovarian syndrome like symptoms.
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Benign Gynaecology:
Fat cells in the body produce the female hormone estrogen and so benign gynaecological conditions like endometrial polyps and fibroids are more commonly seen in obese women possibly due to the effects of excess estrogen.
Contraceptive options in obese women are limited due to risks of medical problems. Surgery in obese women also fall under high risk category due to practical and medical complications.
Obesity is associated with difficulty in spontaneous conception and also affects the success rates of fertility treatment.
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Pregnancy:
Impact of obesity on pregnancy include increased incidence of spontaneous miscarriage, congenital malformations in the baby and complications such as diabetes and high blood pressure during pregnancy. There is also an increased risk of complications during and post delivery to the mother and baby.
It will be ideal to achieve near normal BMI before contemplating pregnancy to minimize complications in pregnancy.
Post reproductive health:
Around the time of menopause there can be an increase in fat mass with redistribution of body fat. Obese women have increased risk of metabolic diseases such as cardiovascular disease and type 2 diabetes.
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The incidence of pelvic floor disorders is higher in obese women. Obesity plays a role in causation of pelvic floor damage resulting in symptoms like urinary incontinence, overactive bladder symptoms and pelvic organ prolapse. Also the outcome following urogynaecological surgeries is guarded in obese women.
Obesity is also associated with an increased risk of endometrial and breast cancer due to raised estrogen levels in the body produced by the fat cells.

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