Over 10 years, Ms. Giang's weight increased from 40 kg to 108 kg, leading to increasingly sparse menstrual cycles, occurring only twice a year for the past two years. She attempted various weight loss methods, including carbohydrate restriction, intense workouts costing tens of millions of dong, and consuming weight-loss teas and coffees, but these proved ineffective. Upon examination at Tam Anh General Hospital Ho Chi Minh City, she weighed 108 kg, was 1,63 m tall, with a body mass index (BMI) of approximately 40.

Doctor Lam Van Hoang, Head of the Endocrinology and Diabetes Department at Tam Anh General Hospital Ho Chi Minh City, stated that Ms. Giang suffered from severe obesity, endocrine disorders, grade two fatty liver, dyslipidemia, and a high risk of gout due to prolonged elevated uric acid levels.

"Menstrual disorders and prolonged bleeding are complications of obesity," Doctor Hoang explained. He added that continuous weight gain leads to excess adipose tissue producing and metabolizing hormones, causing the body to secrete a large amount of estrogen. Estrogen, the main hormone regulating menstruation, can cause the uterine lining to not adapt properly, leading to menstrual irregularities. This estrogen imbalance results in ovulatory dysfunction or anovulation, causing irregular periods.

Doctor Hoang consults Ms. Giang on her weight loss regimen. *Photo: Tam Anh General Hospital*

The doctor advised Ms. Giang to lose at least 10-15% of her body weight to regulate her menstrual cycle and improve reproductive health. She began taking appetite-suppressant medication to reduce hunger and promote satiety, combined with a healthy diet recommended by a nutritionist. Initially, she still ate according to her preferences, but due to the medication, she felt full quickly, reducing her food intake by about one-half compared to her usual amount. For snacks, Ms. Giang added low-sugar fruits, yogurt, and coconut water, while maintaining 15-30 minutes of walking or jumping rope daily.

In the first month of treatment, she lost 5 kg, and after two months, she lost 9 kg. Her menstrual cycle became more regular, occurring every two to three months, and the prolonged bleeding significantly reduced.

Menstrual disorders not only affect endocrine function but also directly increase the risk of infertility, endometrial hyperplasia, and cancer. The most scientific, safe, and effective principle for obesity treatment involves reducing calorie intake while increasing energy expenditure through physical activity and exercise. Doctor Hoang advised against unscientific weight loss methods, such as completely eliminating carbohydrates, which can lead to energy imbalance, dizziness, muscle atrophy, vitamin deficiencies, and severe fluid and electrolyte disturbances.

Duc Hanh

*Patient's name has been changed