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Obese women less likely to have uterine condition

Heavy women are less likely to be diagnosed with endometriosis than their slimmer peers, a new study has found.
The Straits Times - May 23, 2013
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Obese women less likely to have uterine condition

Heavy women are less likely to be diagnosed with endometriosis than their slimmer peers, a new study has found.

Researchers following more than 116,000 women found that morbidly obese participants were 39 per cent less likely than normal-weight women to develop the chronic condition, in which uterine tissue grows outside the uterus and causes painful periods and bleeding.

That link was especially strong among women with infertility, said Dr Divya Shah, from the University of Iowa Hospitals and Clinics in Iowa City in the United States, and her colleagues.

Still, the findings do not prove that carrying around extra weight protects against endometriosis, she said.

"By no means would I suggest ever that someone gain weight to try to reduce the risk of endometriosis," she said.

She and her colleagues used data from a long-term study of female nurses who were tracked beginning in 1989, when they were 25 to 42 years old.

Women reported their height and weight as 18-year-olds and updated researchers on their weight and any new medical diagnoses every two years.

Between 1989 and 2011, about 5,500 of them were diagnosed with endometriosis.

The researchers found both current weight and weight at the age of 18 were tied to a woman's risk of endometriosis - so that the heavier she was, the lower her chance of being diagnosed with the condition.

Among those with fertility problems, in particular, women with a body mass index (BMI) of 40 or above were 62 per cent less likely to develop endometriosis than women on the low end of the normal BMI range, the study team wrote in Human Reproduction.

BMI, a benchmark of fat, is calculated by taking one's weight in kilogrammes and dividing it by the square of one's height in metres.

An adult with a BMI of between 18.5 and 24.9 is considered of normal weight. He is underweight if his BMI is below this range, overweight if it is between 25 and 29.9, and obese if it is 30 or above.

Women with infertility tend to have higher rates of other hormonal conditions, which may explain the especially strong weight association in that group, Dr Shah said.

For example, polycystic ovary syndrome (PCOS) is one cause of infertility, and women with PCOS are often overweight and do not typically get endometriosis. So statistically, that may skew the likelihood of endometriosis in infertile women towards the lower end of the weight spectrum, she said.

Surgery is required for endometriosis to be definitively diagnosed, said Dr Steven Young, who has studied and treated endometriosis at the University of North Carolina at Chapel Hill but was not involved in the new research.

Because of that, there could be other factors that affect who has surgery and is diagnosed, he said. Wealthier women may be more likely to have the procedure, for example, and very obese women - who are at higher risk during any surgery - less likely.

Another possibility is that symptoms of endometriosis start early, leading young women to change their eating habits, and the diagnosis comes much later.

"Women with endometriosis may be less prone to eating; they may feel sick," Dr Young said.

Dr Shah said it often takes a decade or longer for women to be diagnosed once they start having menstrual pain.

The researchers agreed there are still many questions about what could explain the link between weight and endometriosis, especially among women without fertility problems.

For now, Dr Shah said, knowing that association may help researchers looking for the underlying causes of endometriosis and may make doctors more likely to suspect endometriosis in lean women with menstrual pain.



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