On the question of the characteristics of the menstrual cycle in adolescent girls with obesity

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Background. Due to the increasing prevalence of abnormal uterine bleeding (AUB) among obese adolescent girls, a factorial analysis of the probable causes of this pathology is highly relevant.

Aim. To analyze and characterize clinical, hormonal, metabolic features and parameters relevant to the assessment of ovarian reserve in adolescent girls with obesity and AUB.

Materials and methods. The study included 2 groups of obese adolescent girls who have passed at least 12 months from the start of menarche, who do not have endocrine and severe somatic diseases; main group: adolescent girls with obesity (SDS BMI more than 2) and abnormal uterine bleeding of the type of opso-oligomenorrhea and secondary amenorrhea; comparison group: adolescent girls with obesity (SDS BMI more than 2) and absence of menstrual cycle disorders.

Results. Among adolescent girls without AUB, severe forms of obesity (3–4 art.) were more common than in the group with AUB. According to the metabolic status, plasma triglyceride and cholesterol levels were significantly higher in the AUB group compared with adolescent girls without menstrual disorders (p=0.035 and 0.043, respectively).When assessing carbohydrate metabolism, no significant differences between the groups were obtained (p=1.000). According to the results of the study of the hormonal status, no significant differences between the groups were obtained. The hirsute number had no significant differences in the groups. The correlation analysis revealed a positive correlation between the severity of obesity with the HOMA index (p=0.034), a positive correlation of the prolactin level with the hirsute number (p=0.021) and estradiol (p=0.04). The median level of anti-muller hormone in the group with AUB was significantly higher compared to the group without AUB (6.13 ng/ml vs 2.09 ng/ml, p<0.05). When analyzing the follicular apparatus of the ovaries, it was found that the median volume of both the right and left ovaries in girls of group 1 with obesity and the AUB was larger than in the comparison group. The median number of follicles in the section in group 1 also indicated a greater number of them compared to the comparison group.

Conclusion. In the studied groups, girls with a more severe degree of obesity were more often associated with the absence of AUB, but metabolic disorders were more common in the group of girls with AUB. When assessing the ovarian reserve, a direct correlation was obtained between the level of anti-muller hormone and the number of antral follicles in the ovary.

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About the authors

Anastasiya S. Liskina

Almazov National Medical Research Centre

Email: anastoz@mail.ru
ORCID iD: 0000-0003-0307-5553

Res. Officer

Russian Federation, Saint Petersburg

Irina E. Zazerskaia

Almazov National Medical Research Centre

Email: nikitina0901@gmail.com
ORCID iD: 0000-0003-4431-3917

D. Sci. (Med.)

Russian Federation, Saint Petersburg

Tatiana I. Antoshina

Almazov National Medical Research Centre

Email: nikitina0901@gmail.com

Medical Resident

Russian Federation, Saint Petersburg

Sabina R. Safiullina

Almazov National Medical Research Centre

Email: nikitina0901@gmail.com
ORCID iD: 0000-0002-2021-3244

Medical Resident

Russian Federation, Saint Petersburg

Shuaynat A. Dzhamieva

Almazov National Medical Research Centre

Email: nikitina0901@gmail.com
ORCID iD: 0000-0003-2911-1620

Medical Resident

Russian Federation, Saint Petersburg

Irina L. Nikitina

Almazov National Medical Research Centre

Author for correspondence.
Email: nikitina0901@gmail.com
ORCID iD: 0000-0002-3713-5350

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg


  1. Tena-Sempere M. Kisspeptin signaling in the brain: recent developments and future challenges. Mol Cell Endocrinol. 2010;314(2):164-9.
  2. Avendano MS, Vazquez MJ, Tena-Sempere M. Disentangling puberty: novel neuroendocrine pathways and mechanisms for the control of mammalian puberty. Hum Reprod Update. 2017;23(6):737-63. doi: 10.1093/humupd/dmx025
  3. Abreu AP, Kaiser UB. Pubertal development and regulation. Lancet Diabetes Endocrinol. 2016;4(3):254-64. doi: 10.1016/S2213-8587(15)00418-0
  4. Никитина И.Л., Байрамов А.А., Ходулева Ю.Н., Шабанов П.Д. Кисспептины в физиологии и патологии полового развития – новые диагностические и терапевтические возможности. Обзоры по клинической фармакологии и лекарственной терапии. 2014;12(4):3-12 [Nikitina IL, Bairamov AA, Khoduleva YuN, Shabanov PD. Kisspeptins in physiology and pathology of sex development – new diagnostic and therapeutic approaches. Reviews on Clinical Pharmacology and Drug Therapy. 2014;12(4):3-12 (in Russian)].
  5. Ojeda SR, Lomniczi A, Sandau U, et al. New concepts on the control of the onset of puberty. Endocr Dev. 2010;17:44-51. doi: 10.1159/000262527
  6. Loshe S, Cappa M, Ghizzoni L, et al. Pediatric neuroendocrinology. Preface. Endocr Dev. 2010;17:7. doi: 10.1159/isbn.978-3-8055-9644-2
  7. Lomniczi A, Ojeda S.R. The emerging role of epigenetics in the regulation of female puberty. Lessons for clinical management of pubertal disorders. Endocr Dev. 2016;29:1-16. doi: 10.1159/000438840
  8. Munro MG, Critchley HO, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynecol Obstet. 2018;143(3):393-408. doi: 10.1002/ijgo.12666
  9. Oehler MK, Rees MC. Menorrhagia: an update. Acta Obstet Gynecol Scand. 2003;82(5):405-22. doi: 10.1034/j.1600-0412.2003.00097.x
  10. Committee opinion no. 605: primary ovarian insufficiency in adolescents and young women. Obstet Gynecol. 2014;124(1):193-7. doi: 10.1097/01.AOG.0000451757.51964.98
  11. Bhide P, Pundir J, Homburg R, Acharya G. Biomarkers of ovarian reserve in childhood and adolescence: A systematic review. Acta Obstet Gynecol Scand. 2019;98(5):563-72. doi: 10.1111/aogs.13574
  12. Brix N, Ernst A, Lauridsen LLB, et al. Timing of puberty in boys and girls: A population-based study. Paediatr Perinat Epidemiol. 2019;33(1):70-8. doi: 10.1111/ppe.12507
  13. Almog B, Shehata F, Suissa S, et al. Age-related normograms of serum antimüllerian hormone levels in a population of infertile women: a multicenter study. Fertil Steril. 2011;95(7):2359-63, 2363.e1. doi: 10.1016/j.fertnstert.2011.02.057
  14. Webber L, Davies M, Anderson R, et al. European Society for Human Reproduction and Embryology Guideline Group on POI. ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016;31(5):926-37. doi: 10.1093/humrep/dew027
  15. Nelson S, Anderson R. Prediction of premature ovarian insufficiency: foolish fallacy or feasible foresight? Climacteric. 2021;24(5):438-43. doi: 10.1080/13697137.2020.1868426
  16. Никитина И.Л., Тодиева А.М., Каронова Т.Л., Буданова М.В. Ожирение у детей и подростков: особенности фенотипа, ассоциация с компонентами метаболического синдрома. Вопросы детской диетологии. 2012;10(5):23-30 [Nikitina IL, Todieva AM, Karonova TL, Budanova MV. Ozhirenie u detei i podrostkov: osobennosti fenotipa, assotsiatsiia s komponentami metabolicheskogo sindroma. Voprosy detskoi dietologii. 2012;10(5):23-30 (in Russian)].
  17. Никитина И.Л. Детская эндокринология. Учебное пособие для студентов, обучающихся по специальности 040200 Педиатрия. 2006 [Nikitina IL. Detskaia endokrinologiia. Uchebnoe posobie dlia studentov, obuchaiushchikhsia po spetsial'nosti 040200 Pediatriia. 2006 (in Russian)].
  18. Seif MW, Diamond K, Nickkho-Amiry M. Obesity and menstrual disorders. Best Pract Res Clin Obstet Gynaecol. 2015;29(4):516-27. doi: 10.1016/j.bpobgyn.2014.10.010
  19. Аменорея и олигоменорея. Клинические рекомендации Российской Федерации 2021 [Amenoreia i oligomenoreia. Klinicheskie rekomendatsii Rossiiskoi Federatsii 2021 (in Russian)].
  20. Navarro DJ, Foxcroft DR. Learning statistics with jamovi: a tutorial for psychology students and other beginners (Version 0.75). 2022. doi: 10.24384/hgc3-7p15
  21. Borshuliak AV, Andriiets OA, Bakun OV, et al. State of hormonal balance in adolescent girls with menstrual function disorders associated with obesity. J Med Life. 2021;14(6):834-40. doi: 10.25122/jml-2021-0312
  22. Marques P, Madeira T, Gama A. Menstrual cycle among adolescents: girls' awareness and influence of age at menarche and overweight. Rev Paul Pediatr. 2022;40:e2020494. doi: 10.1590/1984-0462/2022/40/2020494
  23. Finer LB, Philbin JM. Trends in ages at key reproductive transitions in the United States, 1951–2010. Womens Health Issues. 2014;24(3):e271-9. doi: 10.1016/j.whi.2014.02.002

Supplementary files

Supplementary Files
1. Fig. 1. Distribution of patients by obesity grade in comparison groups.

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2. Fig. 2. Evaluation of triglyceride levels in comparison groups.

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3. Fig. 3. Evaluation of cholesterol levels in comparison groups.

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4. Fig. 4. Plasma anti-Müllerian hormone (AMH) levels in groups of girls with obesity by presence/absence of abnormal uterine bleeding (AUB).

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5. Fig. 5. Regression analysis of the prediction of the follicle number in the right and left ovaries depending on plasma AMH levels.

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