The relationship between body mass index and menstrual cycle disorder

The relationship between body mass index and menstrual cycle disorder | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The relationship between body mass index and menstrual cycle disorder Rola Salem, Sulaf alghazzawi, Taghrid Hammoud This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4784205/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: The research aims to study the prevalence of menstrual disorders and their relationship with body mass index Methods and materials: A cross-sectional descriptive study that included 392 female patients from the outpatient clinic at Al-Zahrawi Hospital. They met the inclusion criteria and included women aged (20) - (40) years who had no known causes for menstrual irregularity, a detailed clinical history was taken, and a clinical examination was performed that included measuring weight and height. To determine the body mass index using a tape measure and an electronic weight scale and dividing according to the values ​​into four groups, a menstrual history was taken (puberty, date of last menstrual period, regularity of the menstrual cycle). The patients were then divided according to possible patterns of menstrual disorders. An echographic evaluation of the reproductive system was conducted for a period of 3 months, from April 2024 to May 2024. Results: The current study showed that 6.9% of the sample were underweight, 39.3% were normal weight, 32.9% were overweight, 20.9% were obese, 21.2% had normal menstruation, and 78.8% had a menstrual irregularity. We found that there is a statistically significant relationship (P=0.005) between the high incidence of menstrual irregularity with abnormal BMI values, and the percentage of amenorrhea and polymenorrhea was highest among obese women, followed by underweight women. The difference between the groups was statistically significant (P=0.04), (P=0.02), Oligomenorrhea was seen and was higher among overweight women, followed by obese women, and the difference between the groups was statistically significant (P=0.001). The percentage of menorrhagia was higher among obese women, followed by overweight women, then underweight women, and the difference between the groups was statistically significant (P=0.04). Dysmenorrhea was higher among underweight women. Weight, followed by obese, in equal proportion among overweight and normal weight women, with a statistically significant difference (P=0.003). There was no statistically significant difference between the groups for Hypomenorrhea (P=0.5), intermenstrual bleeding (P=0.1), and menorrhagia (P=0.09). Conclusion: Menstrual disorders are common in women of reproductive age. Body mass index plays a very important vital role in the regularity of the menstrual cycle, and weight control is important to improve a woman's quality of life during her reproductive years. Endocrinology & Metabolism menstrual disorders body mass index body fat. Introduction Obesity is a growing public health concern because it is associated with many comorbidities. In addition to rising life expectancy and a growing population, obesity-related diseases are expected to become more prevalent. Women with obesity suffer from menstrual disorders and polycystic ovary syndrome (PCOS). This causes a difference in the amount of blood loss during the menstrual cycle, the length of the menstrual cycle, and the duration of bleeding. Most obese women with PCOS syndrome suffer from a higher frequency of irregular menstrual cycles. However, obesity is an independent risk factor for many hormonal disorders such as increased Testosterone and insulin levels, and low levels of sex hormone binding globulin which certainly affect the menstrual cycle [ 1 ] Obesity in adolescence is one of the factors that contribute to an increased risk of menstrual disorders, as most obese women suffer from oligomenorrhea, amenorrhea, or irregular periods. The relationship between obesity and heavy menstrual bleeding is not well confirmed, as data on its prevalence are limited. Limited, special emphasis should be placed on ruling out endometrial hyperplasia in these women [ 2 ]. The methods of treating menstrual disorders in obese women are similar to those of women of normal weight, however, the therapeutic results in terms of effectiveness and side effects need special attention when treating women with a high body mass index. [ 3 ] Methods and materials Research objective • Study the prevalence of menstrual disorders. • Evaluating the relationship between body mass index and menstrual disorders. Research methods and materials Study type: Descriptive study (cross-sectional) observational descriptive study (cross-sectional) Study sample: The research includes 392 female patients attending outpatient clinics at Al-Zahrawi Hospital in Damascus during a period of 3 months in the year 2024, from April 2024 AD until May 2024 AD. Input criteria: Single and married women aged (20-40) who wish to participate in the study. Exclusion criteria: 1. Pregnant and breastfeeding women 2. The presence of previously diagnosed chronic systemic diseases, such as diabetes, or medical conditions known to affect the menstrual cycle, such as thyroid disorders. 3. A history of chronic gynecological diseases such as polycystic ovary syndrome that may affect the menstrual cycle 4. Patients with a history of pelvic or reproductive tract surgery 5. Women took medications that affect the menstrual cycle or sex hormones for 6 months before the study was conducted. Research variables: quantitative variables: with measures of central tendency, qualitative variables with variables and percentages Research Methodology: With the assistance of the resident physician, the subject of the research was first explained, the patient’s questions were answered, and her written informed consent was obtained. The patient was fully interrogated and a detailed clinical history was taken, including pregnancy history, if any, and questions about family, medical, surgical, drug, and allergic antecedents. A detailed menstrual history was taken (age of puberty, date of last menstrual period, menstrual regularity, intervals between menstrual cycles, duration of menstruation, amount of menstrual blood, relationship of pain to menstruation). The menstrual cycle pattern was regular (28±7) days, with menstrual flow lasting (4±2) days and moderate blood loss (20-60) ml. Patients were divided according to possible patterns of menstrual disorders into: Amenorrhea, meaning its absence for six consecutive months in women who suffer from irregular menstrual cycles or fewer than nine cycles per year. Menstrual spacing if the interval between periods is more than 38 days and less than 90 days. Premenopause if the interval between cycles is less than 21 days. Prolonged menstruation if the duration of menstruation is more than 8 days. Menorrhagia if the amount of menstrual blood is more than 80 ml (using the blood loss assessment chart). Oligomenorrhea if the amount of menstrual blood is less than 5 ml or the duration of menstruation is less than (1-2) days and the presence or absence of dysmenorrhea. A clinical examination was conducted, including measuring height and weight to determine the body mass index using a tape measure and an electronic weight scale, and dividing the values into four categories according to the World Health Organization: • Weight loss: < 18.5 kg/m2. • Normal weight: ≥ (18.5-24.9) kg/m2. • Overweight: ≥ (25-29.9) kg/m2. • Obesity: ≥ 30 kg/m2. An ultrasonographic evaluation was performed, including examination of the reproductive system (ovaries and uterus) to detect abnormalities. Statistical study: Descriptive statistics: Quantitative variables: with measures of central tendency. Qualitative variables: variables and percentages. Inferential statistics: Based on the laws of statistics: One Way ANOVA test to compare the means of several independent groups. Chi-Square or Fisher exact test to study the relationship between qualitative variables. The results are considered statistically significant with P-value < 0.05. Adopting the program (IBM SPSS Statistics Version28) to calculate statistical coefficients and analyze the results. Results 392 women attending the outpatient clinic at Al-Zahrawi Hospital in Damascus participated in the research during a period of 3 months in the year 2024 and met the inclusion criteria in the research. The ages of the women in the research ranged from (20–40 years), with an average age of (27.23 ± 5.6 years), and the age of puberty ranged from (9–15 years), with an average of (11.2 ± 1.3 years). The weight of the women in the research ranged from (46–98 kg), with an average weight of (66.33 ± 8.3 kg), and the height of the women ranged from (150–173 cm), with an average of (163.25 ± 9.8 cm). He was (27.23 ± 5.6 years) and his average body mass index was (25.95 ± 4.2 kg/m2). In our studies, we found that the percentage of normal weight women was 39.3%, the percentage of overweight women was 32.9%, the percentage of obese women was 20.9%, and the percentage of underweight women was 6.9%. In our study, we found that 53.1% of the research sample were single women, and 46.9% were married women. In our study, we found that the percentage of women who have a menstrual disorder is 78.8%, while the percentage of women who have normal menstruation is 21.2%. In our study, we found that the percentage of amenorrhea was 58.2%, the percentage of dysmenorrhea was 32.6%, the percentage of menorrhagia was 14.8%, the percentage of oligomenorrhea was 13.3%, the percentage of amenorrhea was 10.2%, the percentage of polymenorrhea was 5.1%, and the percentage of amenorrhea was and intermenstrual bleeding, 2.04% each. By studying the differences in distribution according to BMI groups according to the average values ​​for age, we found that the average age of women who are underweight is 24.78 years, with a standard deviation of 2.03 years, and the average age of women who are normal weight is 25.49 years, with a standard deviation of 3.8 years, and the average age of women who have The average age of overweight women was 27.92 years, with a standard deviation of 3.2 years, and the average age of obese women was 26.39 years, with a standard deviation of 2.9 years, without any statistically significant differences. By studying the differences in distribution according to BMI groups according to the average values ​​of weight, we found that the average weight of women who are underweight is 48.22 ± 1.9 kg, the average weight of women who are normal weight is 60.12 ± 3.2 kg, and the average weight of women who are overweight is 73.21 ± 5.8. kg, and the average weight of obese women is 91.68 ± 4.9 kg, with statistically significant differences. By studying the differences in distribution according to BMI groups according to the average values ​​of height, it was found that the average height of those who were underweight was 162.33 cm with a standard deviation of 6.3 cm, the average height of those who were normal weight was 163.75 cm with a standard deviation of 8.2 cm, and the average height of those who were overweight was 161.21 cm. With a standard deviation of 5.8 cm, the average height of those with obesity was 161.98 cm, with a standard deviation of 5.8 cm, without any statistically significant differences. By applying the By applying the Weight 88.9%, then overweight women 86.1%, then normal weight 6.3%. The percentage of menopause was highest in the obese group at 7.3%, followed by underweight women at 3.7%, then overweight women at 0.8%, with statistically significant differences. The percentage of amenorrhea was highest among overweight women, 71.3%, followed by obese women, 63.4%, with statistically significant differences. The percentage of amenorrhea was highest in the obese group, 19.5%, followed by underweight women, 14.8%, and overweight women, 9.3%, with statistically significant differences. The percentage of menorrhagia was highest among obese women at 23.2%, followed by overweight women at 17.1%, and the difference between the groups was statistically significant. The percentage of oligomenorrhea was similar in the four groups, without a statistically significant difference. We did not notice any statistically significant differences with regard to bleeding between menorrhagia and prolongation. The percentage of dysmenorrhea was highest among underweight women, 81.5%, followed by obese women, 41.5%. The percentages were close among overweight women, 25.6%, and normal weight women, 25.3%, with statistically significant differences. Discussion The current study was conducted to evaluate the prevalence of menstrual disorders and to determine the relationship between body mass index and the occurrence of these disorders. The study included 392 women attending outpatient clinics at Al-Zahrawi Hospital during a three-month period in 2024, of which 53.1% were single and 46.9% were married. Their average age was 27.23 ± 5.6 years and the average age of puberty was 11.2 ± 1.3 years. 39.3% of the sample were normal weight, 32.9% were overweight, 20.9% were obese, and 6.9% were underweight, and the average body mass index (BMI) was 25.95 ± 4.2 kg/m2. The study found that the average age of underweight females is younger than that of normal, overweight, and obese women. This may be due to the role of pregnancy and childbirth in weight gain at older ages, or it may be due to a hormonal imbalance or diabetes. The percentage of menstrual disorder in the study sample was 78.8% and was higher among women. Obese women 91.5%, underweight women 88.9%, and overweight women 86.1%, of the normal weight group 62.3%. The current study showed that amenorrhea is the most common disorder in 58.2% of the research sample, followed by dysmenorrhea 32.6%, and the percentages were close for menorrhagia and menorrhagia. The proportions of menopause, amenorrhea, and intermenstrual bleeding converged (14.8%, 13.3%, 10.2%, respectively). This study indicates that the percentage of amenorrhea is higher in the obese group. 7.3%, followed by underweight women 3.7%, then overweight women 0.8%, with statistically significant differences. The percentage of amenorrhea is highest among overweight women at 71.3%, followed by obese women at 63.4%, with significant statistically significant differences, as well as the percentage of presence of Amenorrhea was highest among the obese group at 19.5%, followed by underweight women at 14.8%, then overweight women at 9.3%, with statistically significant differences. The percentage of menorrhagia was higher among obese women at 23.2%, followed by overweight women at 17.1%, and the difference between the groups was significant. An important statistic: the percentage of dysmenorrhea was close in the above four groups among underweight women, 14.8%, without a statistically significant difference. We did not notice significant statistical differences with regard to intermenstrual bleeding and prolongation, while the percentage of dysmenorrhea was higher among underweight women, 81.5. %, followed by obese women at 41.5%, and the percentages were close for overweight women at 22.6% and normal weight women at 25.3%. Conclusion Our current study showed that menstrual cycle disorders were common in women of reproductive age, at a rate of 78.8%, and higher among obese women (91.5%), underweight women (88.9%), and overweight women (86.1%), than in the normal weight group (62.3%), with statistically significant differences, and that menstrual spacing is The most common disorder is 58.2%, followed by dysmenorrhea 32.6%. High or low values of the BMI play an important vital role in the occurrence of these disorders, as a statistically significant relationship has been shown between the BMI and amenorrhea, amenorrhea, amenorrhea, menorrhagia, and dysmenorrhea. There were no significant differences between BMI and each of oligomenorrhea, prolongation of menstruation, and intermenstrual bleeding. Recommendations: 1. Women are recommended to maintain weight within acceptable health limits to promote regular menstrual cycles and improve the woman’s quality of life during her reproductive years. 2. Health education for females about menstrual disorders and the problems resulting from them, starting at puberty. 3. We must take into account all the factors that contribute to menstrual irregularity and not forget the role of the weight factor in this. 4. Conduct longer prospective studies to follow up the return of menstrual regularity after adjusting BMI values. Declarations Ethical approval: The Research Ethics Committee at Syrian Private University and the ethical committees at the relevant Syrian Private University approved the study protocol. Verbal informed consent was obtained from the participant All procedures performed in studies involving the participant and human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards Consent for publication: Not applicable. Availability of data and materials: All data produced in the present work are contained in the manuscript Conflict of interest: The authors declare that they have no Conflict of interest: Funding: Unavailable Acknowledgments: We are thankful to the management of the Syrian Private University for their support in the eld of medical training and research. We would also like to thank Dr. Taghrid Hammoud for his help and supervision in the paper, we would like to thank the male and female students participating in the study. References Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 219 years: United States, 19631965 through 20172018. NCHS Health E-Stats; 2020. Obesity and overweight. World Health Organization. Updated June 9, 2021. Available at: https://www. who.int/news- room/ fact-sheets/detail/obesity-and-overweight. Accessed March 26, 2022. Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics 2018;141(3): e20173459. https://doi.org/ 10.1542/peds.2017-3459: MarErratum in: Pediatrics. 2018 Sep;142(3): PMID: 29483202; PMCID: PMC6109602. Additional Declarations The authors declare potential competing interests as follows: All authors have read the paper and approved publication Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4784205","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":330379144,"identity":"9ea4c888-f940-4824-b9d6-a204f2bc9269","order_by":0,"name":"Rola Salem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYFAC5gaGDwYSPGzMzAcfALk8fIS1MDYwzqiwkeNjZ0s2AGlhI0YLM8+ZNGM5fh41CRCfoBbz9sbGD7xthxPbmHnYKr/m2MmwMTA/fHQDjxaZMwebJSTBWniP3Zbdlgx0GJuxcQ4eLRISiQ0ShmAtfGm3JbcB7QJ6R5qAluYfiRCHmRVLbqsnSkubxAGg99mAWhg/bjtMhBaeg22WDcBAZmNmS5Zm3HYcGEGE/MLefPj2H2BUyvcfPvjx57Zqe3725oeP8WlBAcw8YJJY5SDA+IMU1aNgFIyCUTBiAADH90Ifs0VvTgAAAABJRU5ErkJggg==","orcid":"","institution":"Faculty of medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":true,"prefix":"","firstName":"Rola","middleName":"","lastName":"Salem","suffix":""},{"id":330379145,"identity":"e6416d8c-c27b-4445-b55a-8055f985ae41","order_by":1,"name":"Sulaf alghazzawi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYFAC5gaGCgMbOzaGwweAPAkZIrQwNjCcKUhL5mM8lgDSwkOklg+HGecxnzEAcQlrkZ+R2PjhgAEzMxvbmc+vbtRY8DCwHz66AZ8WgxuJzRIHDNj42HjObrPOOQZ0GE9a2g28WiQSG6Q/GPAws0mc3WacwwbUIsFjhlcL0GHNPw4YSDC2yb95ZpzzjwgtDDcS24AOM2BsYzjD/Di3jQgtBmcetlkcMEhIZmM4Zsac2yfBw0bIL/LtyYdvHPjz306+4fDjzznf6uT42Q8fw+8wJMAmASaJVQ4CzB9IUT0KRsEoGAUjBwAAeZ1K7IM6CxcAAAAASUVORK5CYII=","orcid":"","institution":"Faculty of medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":true,"prefix":"","firstName":"Sulaf","middleName":"","lastName":"alghazzawi","suffix":""},{"id":330379146,"identity":"9538d958-c30a-4357-b951-72cb2c41be8d","order_by":2,"name":"Taghrid Hammoud","email":"","orcid":"","institution":"Department of Internal Medicine, Syrian Private University, Damascus, Syria.","correspondingAuthor":false,"prefix":"","firstName":"Taghrid","middleName":"","lastName":"Hammoud","suffix":""}],"badges":[],"createdAt":"2024-07-22 20:07:29","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4784205/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4784205/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60874334,"identity":"7eafcfef-ae4a-4bad-b4e0-d112c25663af","added_by":"auto","created_at":"2024-07-23 05:31:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":225830,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4784205/v1/8038e280-7ea3-41fa-8c8b-10c6ec592284.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: All authors have read the paper and approved publication","formattedTitle":"\u003cp\u003e\u003cstrong\u003eThe relationship between body mass index and menstrual cycle disorder\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObesity is a growing public health concern because it is associated with many comorbidities. In addition to rising life expectancy and a growing population, obesity-related diseases are expected to become more prevalent. Women with obesity suffer from menstrual disorders and polycystic ovary syndrome (PCOS). This causes a difference in the amount of blood loss during the menstrual cycle, the length of the menstrual cycle, and the duration of bleeding. Most obese women with PCOS syndrome suffer from a higher frequency of irregular menstrual cycles. However, obesity is an independent risk factor for many hormonal disorders such as increased Testosterone and insulin levels, and low levels of sex hormone binding globulin which certainly affect the menstrual cycle [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eObesity in adolescence is one of the factors that contribute to an increased risk of menstrual disorders, as most obese women suffer from oligomenorrhea, amenorrhea, or irregular periods. The relationship between obesity and heavy menstrual bleeding is not well confirmed, as data on its prevalence are limited. Limited, special emphasis should be placed on ruling out endometrial hyperplasia in these women [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe methods of treating menstrual disorders in obese women are similar to those of women of normal weight, however, the therapeutic results in terms of effectiveness and side effects need special attention when treating women with a high body mass index. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e"},{"header":"Methods and materials","content":"\u003cp\u003eResearch objective\u003c/p\u003e\n\u003cp\u003e• Study the prevalence of menstrual disorders.\u003c/p\u003e\n\u003cp\u003e• Evaluating the relationship between body mass index and menstrual disorders.\u003c/p\u003e\n\u003cp\u003eResearch methods and materials\u003c/p\u003e\n\u003cp\u003eStudy type: Descriptive study (cross-sectional)\u003c/p\u003e\n\u003cp\u003eobservational descriptive study (cross-sectional)\u003c/p\u003e\n\u003cp\u003eStudy sample: The research includes 392 female patients attending outpatient clinics at Al-Zahrawi Hospital in Damascus during a period of 3 months in the year 2024, from April 2024 AD until May 2024 AD.\u003c/p\u003e\n\u003cp\u003eInput criteria:\u003c/p\u003e\n\u003cp\u003eSingle and married women aged (20-40) who wish to participate in the study.\u003c/p\u003e\n\u003cp\u003eExclusion criteria:\u003c/p\u003e\n\u003cp\u003e1. Pregnant and breastfeeding women\u003c/p\u003e\n\u003cp\u003e2. The presence of previously diagnosed chronic systemic diseases, such as diabetes, or medical conditions known to affect the menstrual cycle, such as thyroid disorders.\u003c/p\u003e\n\u003cp\u003e3. A history of chronic gynecological diseases such as polycystic ovary syndrome that may affect the menstrual cycle\u003c/p\u003e\n\u003cp\u003e4. Patients with a history of pelvic or reproductive tract surgery\u003c/p\u003e\n\u003cp\u003e5. Women took medications that affect the menstrual cycle or sex hormones for 6 months before the study was conducted.\u003c/p\u003e\n\u003cp\u003eResearch variables: quantitative variables: with measures of central tendency, qualitative variables with variables and percentages\u003c/p\u003e\n\u003cp\u003eResearch Methodology:\u003c/p\u003e\n\u003cp\u003eWith the assistance of the resident physician, the subject of the research was first explained, the patient’s questions were answered, and her written informed consent was obtained. The patient was fully interrogated and a detailed clinical history was taken, including pregnancy history, if any, and questions about family, medical, surgical, drug, and allergic antecedents.\u003c/p\u003e\n\u003cp\u003eA detailed menstrual history was taken (age of puberty, date of last menstrual period, menstrual regularity, intervals between menstrual cycles, duration of menstruation, amount of menstrual blood, relationship of pain to menstruation).\u003c/p\u003e\n\u003cp\u003eThe menstrual cycle pattern was regular (28±7) days, with menstrual flow lasting (4±2) days and moderate blood loss (20-60) ml.\u003c/p\u003e\n\u003cp\u003ePatients were divided according to possible patterns of menstrual disorders into:\u003c/p\u003e\n\u003cp\u003eAmenorrhea, meaning its absence for six consecutive months in women who suffer from irregular menstrual cycles or fewer than nine cycles per year.\u003c/p\u003e\n\u003cp\u003eMenstrual spacing if the interval between periods is more than 38 days and less than 90 days.\u003c/p\u003e\n\u003cp\u003ePremenopause if the interval between cycles is less than 21 days.\u003c/p\u003e\n\u003cp\u003eProlonged menstruation if the duration of menstruation is more than 8 days.\u003c/p\u003e\n\u003cp\u003eMenorrhagia if the amount of menstrual blood is more than 80 ml (using the blood loss assessment chart).\u003c/p\u003e\n\u003cp\u003eOligomenorrhea if the amount of menstrual blood is less than 5 ml or the duration of menstruation is less than (1-2) days and the presence or absence of dysmenorrhea.\u003c/p\u003e\n\u003cp\u003eA clinical examination was conducted, including measuring height and weight to determine the body mass index using a tape measure and an electronic weight scale, and dividing the values into four categories according to the World Health Organization:\u003c/p\u003e\n\u003cp\u003e• Weight loss: \u0026lt; 18.5 kg/m2.\u003c/p\u003e\n\u003cp\u003e• Normal weight: ≥ (18.5-24.9) kg/m2.\u003c/p\u003e\n\u003cp\u003e• Overweight: ≥ (25-29.9) kg/m2.\u003c/p\u003e\n\u003cp\u003e• Obesity: ≥ 30 kg/m2.\u003c/p\u003e\n\u003cp\u003eAn ultrasonographic evaluation was performed, including examination of the reproductive system (ovaries and uterus) to detect abnormalities.\u003c/p\u003e\n\u003cp\u003eStatistical study:\u003c/p\u003e\n\u003cp\u003eDescriptive statistics:\u003c/p\u003e\n\u003cp\u003eQuantitative variables: with measures of central tendency.\u003c/p\u003e\n\u003cp\u003eQualitative variables: variables and percentages.\u003c/p\u003e\n\u003cp\u003eInferential statistics:\u003c/p\u003e\n\u003cp\u003eBased on the laws of statistics:\u003c/p\u003e\n\u003cp\u003eOne Way ANOVA test to compare the means of several independent groups.\u003c/p\u003e\n\u003cp\u003eChi-Square or Fisher exact test to study the relationship between qualitative variables.\u003c/p\u003e\n\u003cp\u003eThe results are considered statistically significant with P-value \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eAdopting the program (IBM SPSS Statistics Version28) to calculate statistical coefficients and analyze the results.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e392 women attending the outpatient clinic at Al-Zahrawi Hospital in Damascus participated in the research during a period of 3 months in the year 2024 and met the inclusion criteria in the research.\u003c/p\u003e \u003cp\u003eThe ages of the women in the research ranged from (20\u0026ndash;40 years), with an average age of (27.23\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6 years), and the age of puberty ranged from (9\u0026ndash;15 years), with an average of (11.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3 years).\u003c/p\u003e \u003cp\u003eThe weight of the women in the research ranged from (46\u0026ndash;98 kg), with an average weight of (66.33\u0026thinsp;\u0026plusmn;\u0026thinsp;8.3 kg), and the height of the women ranged from (150\u0026ndash;173 cm), with an average of (163.25\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8 cm).\u003c/p\u003e \u003cp\u003eHe was (27.23\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6 years) and his average body mass index was (25.95\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2 kg/m2).\u003c/p\u003e \u003cp\u003eIn our studies, we found that the percentage of normal weight women was 39.3%, the percentage of overweight women was 32.9%, the percentage of obese women was 20.9%, and the percentage of underweight women was 6.9%.\u003c/p\u003e \u003cp\u003eIn our study, we found that 53.1% of the research sample were single women, and 46.9% were married women.\u003c/p\u003e \u003cp\u003eIn our study, we found that the percentage of women who have a menstrual disorder is 78.8%, while the percentage of women who have normal menstruation is 21.2%.\u003c/p\u003e \u003cp\u003eIn our study, we found that the percentage of amenorrhea was 58.2%, the percentage of dysmenorrhea was 32.6%, the percentage of menorrhagia was 14.8%, the percentage of oligomenorrhea was 13.3%, the percentage of amenorrhea was 10.2%, the percentage of polymenorrhea was 5.1%, and the percentage of amenorrhea was and intermenstrual bleeding, 2.04% each.\u003c/p\u003e \u003cp\u003eBy studying the differences in distribution according to BMI groups according to the average values ​​for age, we found that the average age of women who are underweight is 24.78 years, with a standard deviation of 2.03 years, and the average age of women who are normal weight is 25.49 years, with a standard deviation of 3.8 years, and the average age of women who have The average age of overweight women was 27.92 years, with a standard deviation of 3.2 years, and the average age of obese women was 26.39 years, with a standard deviation of 2.9 years, without any statistically significant differences.\u003c/p\u003e \u003cp\u003eBy studying the differences in distribution according to BMI groups according to the average values ​​of weight, we found that the average weight of women who are underweight is 48.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9 kg, the average weight of women who are normal weight is 60.12\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2 kg, and the average weight of women who are overweight is 73.21\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8. kg, and the average weight of obese women is 91.68\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9 kg, with statistically significant differences.\u003c/p\u003e \u003cp\u003eBy studying the differences in distribution according to BMI groups according to the average values ​​of height, it was found that the average height of those who were underweight was 162.33 cm with a standard deviation of 6.3 cm, the average height of those who were normal weight was 163.75 cm with a standard deviation of 8.2 cm, and the average height of those who were overweight was 161.21 cm. With a standard deviation of 5.8 cm, the average height of those with obesity was 161.98 cm, with a standard deviation of 5.8 cm, without any statistically significant differences.\u003c/p\u003e \u003cp\u003eBy applying the\u003c/p\u003e \u003cp\u003eBy applying the Weight 88.9%, then overweight women 86.1%, then normal weight 6.3%.\u003c/p\u003e \u003cp\u003eThe percentage of menopause was highest in the obese group at 7.3%, followed by underweight women at 3.7%, then overweight women at 0.8%, with statistically significant differences.\u003c/p\u003e \u003cp\u003eThe percentage of amenorrhea was highest among overweight women, 71.3%, followed by obese women, 63.4%, with statistically significant differences.\u003c/p\u003e \u003cp\u003eThe percentage of amenorrhea was highest in the obese group, 19.5%, followed by underweight women, 14.8%, and overweight women, 9.3%, with statistically significant differences.\u003c/p\u003e \u003cp\u003eThe percentage of menorrhagia was highest among obese women at 23.2%, followed by overweight women at 17.1%, and the difference between the groups was statistically significant.\u003c/p\u003e \u003cp\u003eThe percentage of oligomenorrhea was similar in the four groups, without a statistically significant difference.\u003c/p\u003e \u003cp\u003eWe did not notice any statistically significant differences with regard to bleeding between menorrhagia and prolongation.\u003c/p\u003e \u003cp\u003eThe percentage of dysmenorrhea was highest among underweight women, 81.5%, followed by obese women, 41.5%. The percentages were close among overweight women, 25.6%, and normal weight women, 25.3%, with statistically significant differences.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe current study was conducted to evaluate the prevalence of menstrual disorders and to determine the relationship between body mass index and the occurrence of these disorders.\u003c/p\u003e \u003cp\u003eThe study included 392 women attending outpatient clinics at Al-Zahrawi Hospital during a three-month period in 2024, of which 53.1% were single and 46.9% were married. Their average age was 27.23\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6 years and the average age of puberty was 11.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3 years.\u003c/p\u003e \u003cp\u003e39.3% of the sample were normal weight, 32.9% were overweight, 20.9% were obese, and 6.9% were underweight, and the average body mass index (BMI) was 25.95\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2 kg/m2.\u003c/p\u003e \u003cp\u003eThe study found that the average age of underweight females is younger than that of normal, overweight, and obese women. This may be due to the role of pregnancy and childbirth in weight gain at older ages, or it may be due to a hormonal imbalance or diabetes. The percentage of menstrual disorder in the study sample was 78.8% and was higher among women. Obese women 91.5%, underweight women 88.9%, and overweight women 86.1%, of the normal weight group 62.3%. The current study showed that amenorrhea is the most common disorder in 58.2% of the research sample, followed by dysmenorrhea 32.6%, and the percentages were close for menorrhagia and menorrhagia. The proportions of menopause, amenorrhea, and intermenstrual bleeding converged (14.8%, 13.3%, 10.2%, respectively). This study indicates that the percentage of amenorrhea is higher in the obese group. 7.3%, followed by underweight women 3.7%, then overweight women 0.8%, with statistically significant differences. The percentage of amenorrhea is highest among overweight women at 71.3%, followed by obese women at 63.4%, with significant statistically significant differences, as well as the percentage of presence of Amenorrhea was highest among the obese group at 19.5%, followed by underweight women at 14.8%, then overweight women at 9.3%, with statistically significant differences. The percentage of menorrhagia was higher among obese women at 23.2%, followed by overweight women at 17.1%, and the difference between the groups was significant. An important statistic: the percentage of dysmenorrhea was close in the above four groups among underweight women, 14.8%, without a statistically significant difference. We did not notice significant statistical differences with regard to intermenstrual bleeding and prolongation, while the percentage of dysmenorrhea was higher among underweight women, 81.5. %, followed by obese women at 41.5%, and the percentages were close for overweight women at 22.6% and normal weight women at 25.3%.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur current study showed that menstrual cycle disorders were common in women of reproductive age, at a rate of 78.8%, and higher among obese women (91.5%), underweight women (88.9%), and overweight women (86.1%), than in the normal weight group (62.3%), with statistically significant differences, and that menstrual spacing is The most common disorder is 58.2%, followed by dysmenorrhea 32.6%. High or low values of the BMI play an important vital role in the occurrence of these disorders, as a statistically significant relationship has been shown between the BMI and amenorrhea, amenorrhea, amenorrhea, menorrhagia, and dysmenorrhea. There were no significant differences between BMI and each of oligomenorrhea, prolongation of menstruation, and intermenstrual bleeding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1. Women are recommended to maintain weight within acceptable health limits to promote regular menstrual cycles and improve the woman’s quality of life during her reproductive years.\u003c/p\u003e\n\u003cp\u003e2. Health education for females about menstrual disorders and the problems resulting from them, starting at puberty.\u003c/p\u003e\n\u003cp\u003e3. We must take into account all the factors that contribute to menstrual irregularity and not forget the role of the weight factor in this.\u003c/p\u003e\n\u003cp\u003e4. Conduct longer prospective studies to follow up the return of menstrual regularity after adjusting BMI values.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Research Ethics Committee at Syrian Private University and the ethical committees at the relevant Syrian Private University approved the study protocol. Verbal informed consent was obtained from the participant All procedures performed in studies involving the participant and human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data produced in the present work are contained in the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no Conflict of interest:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnavailable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are thankful to the management of the Syrian Private University for their support in the eld of medical training and research. We would also like to thank Dr. Taghrid Hammoud for his help and supervision in the paper, we would like to thank the male and female students participating in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eFryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 219 years: United States, 19631965 through 20172018. NCHS Health E-Stats; 2020.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eObesity and overweight. World Health Organization. Updated June 9, 2021. Available at:\u0026nbsp;https://www.\u0026nbsp;who.int/news-\u0026nbsp;room/\u0026nbsp;fact-sheets/detail/obesity-and-overweight. Accessed March 26, 2022.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSkinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics 2018;141(3): e20173459. https://doi.org/ 10.1542/peds.2017-3459: MarErratum in: Pediatrics. 2018 Sep;142(3): PMID: 29483202; PMCID: PMC6109602.\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"5ec70efb-1a08-4c6c-85a2-5bb8dd9d1d06","identifier":"10.13039/100016418","name":"B.K. Kee Foundation","awardNumber":"0996066591","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Syrian Private University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"menstrual disorders, body mass index, body fat.","lastPublishedDoi":"10.21203/rs.3.rs-4784205/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4784205/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: The research aims to study the prevalence of menstrual disorders and their relationship with body mass index\u003c/p\u003e\n\u003cp\u003eMethods and materials: A cross-sectional descriptive study that included 392 female patients from the outpatient clinic at Al-Zahrawi Hospital. They met the inclusion criteria and included women aged (20) - (40) years who had no known causes for menstrual irregularity, a detailed clinical history was taken, and a clinical examination was performed that included measuring weight and height. To determine the body mass index using a tape measure and an electronic weight scale and dividing according to the values ​​into four groups, a menstrual history was taken (puberty, date of last menstrual period, regularity of the menstrual cycle). The patients were then divided according to possible patterns of menstrual disorders. An echographic evaluation of the reproductive system was conducted for a period of 3 months, from April 2024 to May 2024.\u003c/p\u003e\n\u003cp\u003eResults: The current study showed that 6.9% of the sample were underweight, 39.3% were normal weight, 32.9% were overweight, 20.9% were obese, 21.2% had normal menstruation, and 78.8% had a menstrual irregularity. We found that there is a statistically significant relationship (P=0.005) between the high incidence of menstrual irregularity with abnormal BMI values, and the percentage of amenorrhea and polymenorrhea was highest among obese women, followed by underweight women. The difference between the groups was statistically significant (P=0.04), (P=0.02), Oligomenorrhea was seen and was higher among overweight women, followed by obese women, and the difference between the groups was statistically significant (P=0.001). The percentage of menorrhagia was higher among obese women, followed by overweight women, then underweight women, and the difference between the groups was statistically significant (P=0.04). Dysmenorrhea was higher among underweight women. Weight, followed by obese, in equal proportion among overweight and normal weight women, with a statistically significant difference (P=0.003). There was no statistically significant difference between the groups for Hypomenorrhea (P=0.5), intermenstrual bleeding (P=0.1), and menorrhagia (P=0.09).\u003c/p\u003e\n\u003cp\u003eConclusion: Menstrual disorders are common in women of reproductive age. Body mass index plays a very important vital role in the regularity of the menstrual cycle, and weight control is important to improve a woman's quality of life during her reproductive years.\u003c/p\u003e","manuscriptTitle":"The relationship between body mass index and menstrual cycle disorder","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-23 05:23:11","doi":"10.21203/rs.3.rs-4784205/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7a57bc51-b72a-439c-b304-40b7c467372c","owner":[],"postedDate":"July 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34973895,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2024-07-23T05:23:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-23 05:23:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4784205","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4784205","identity":"rs-4784205","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}