The Link Between Your Weight And Your Monthly Cycle

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Obesity has been linked to everything from diabetes to heart disease. But few people know one of the most prominent risks of excess weight: Endometrial hyperplasia, a condition where the lining of the uterus becomes too thick. It’s not cancer, but in some cases, it can lead to cancer of the uterus.

I consulted with Adnan Munkarah, M.D., who leads Women’s Health Services at Henry Ford Health System. As a gynecologist specializing in ovarian and uterine cancer, he highlights the long-term implications of this little-known condition.

“The reality is that excess weight exposes women to many dangers beyond high blood pressure and elevated cholesterol (both of which are linked to heart disease),” explains Dr. Munkarah. Fat cells don’t just sit on your hips. They’re active hormone factories releasing inflammatory proteins into the bloodstream. Over time, those proteins convert to estrogen wreaking havoc on the endometrium.

Hormones 101

The lining of the uterus, or endometrium, changes throughout the menstrual cycle. During the first part of the cycle, your ovaries produce estrogen, which encourages the uterine lining to divide and multiply. The goal, of course, is to build up the thick uterine lining required to support a pregnancy.

Your body releases an egg during the middle of the cycle and produces progesterone to nourish the endometrium. If the egg isn’t fertilized, hormone levels drop, your body sheds the lining, you get your period and the cycle begins again.

The trouble comes in when women produce excess estrogen during the cycle without the accompanying progesterone—and that’s a common occurrence in women who are overweight or obese since fat underneath the skin produces estrogen.

“The more estrogen circulating in the bloodstream, the more the uterine lining multiplies,” says Dr. Munkarah. “When estrogen levels remain high for an extended period of time, the endometrial cells continue multiplying and dividing fueling the development of abnormal cells called hyperplasia that can lead to cancer in some women.”

While endometrial hyperplasia and uterine cancer are most common among women who have undergone menopause (when ovulation stops and the body no longer makes progesterone), it can also occur in younger women who are overweight.

How Endometrial Hyperplasia Can Be Prevented

With the iron-clad link between obesity and endometrial changes, losing weight is your best bet for lowering your risk of endometrial disease. In fact, studies show that women who shed pounds through diet, exercise or even bariatric surgery are at lower risk of developing endometrial disease.

“For women who are young and overweight, sometimes adjusting their weight is enough to regulate their menstrual cycle and stop endometrial overgrowth,” says Dr. Munkarah, who says the best long-term protection is a healthy diet, regular exercise and sufficient sleep—all three regulate weight and impact how the body functions, including your heart, hormones and more.

Medications including birth control pills and the diabetes drug, metformin, may also help regulate menstrual cycles and reduce the risk of endometrial hyperplasia. (Diabetes is associated with an increased risk of endometrial cancer.)

Signs & Symptoms to Watch

The most common sign of endometrial hyperplasia is irregular bleeding. Menstrual periods that are heavier than normal, or last longer than the standard 5-7 days may signal endometrial overgrowth. Short cycles, too, that are under 21 days may be a sign of trouble. “Sometimes these symptoms develop around menopause when periods become less frequent,” says Dr. Munkarah.

Regardless of when symptoms arise, Dr. Munkarah encourages women to get checked out if they experience abnormal bleeding during menses. Your doctor may perform a variety of diagnostic tests to assess whether your endometrium is abnormally thick. If it is, shedding a few pounds can make a big difference.


If you are concerned about how your weight may be affecting your health, make an appointment with your doctor today.

The Henry Ford Women’s Heart Center is designed to provide life-changing support to women with heart disease or cardiovascular risk factors. Learn more about how a comprehensive Lifestyle Enhancement Visit may help you or call (313) 876-4540 to make an appointment.

Categories: FeelWell

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