British Medical Bulletin 53:341-358 (1997)
© 1997 The British Council
research-article |
Obsesity and female reproductive function
Department of Obstetrics and Gynaeclogy, St.Thomas' Hospital London, UK
Correspondence to: Miss D Hamilton-Fairley, Department of Obstretrics and Gynaecology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
Abstract
Obesity has consistently been demonstrated to have a detrimental effect upon the female reproductive system. This review explores the common association of obesity with polycystic ovary syndrome (PCOS), the effect of obesity on the clinical and endocrinological parameters, and the role of insulin resistance in the expression of this disorder. An improvement in menstrual function, a decrease in the clinical androgenic profile, and significant increase in spontaneous pregnancy rates have been reported following weight 1oss. Obesity is associated with poor pregnancy outcome and miscarriage in both women with PCOS, and in those with normal ovarian morphology. The optimal weight gain during pregnancy remains controversial, but obesity is a risk factor for both maternal and fetal complications, and dietary advice should be offered on an individual basis according to the prepregnancy BMI. Weight gain at the time of menopause is common, and dietary advice is paramount as obesity is an independent risk factor for thrombosis, coronary heart disease (CHD), and breast and endometrial cancer. Effective nutritional counselling should be ohred at all stages of the female reproductive lifecycle.
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