THE ASSOCIATION BETWEEN BODY MASS INDEX AND ABNORMAL UTERINE BLEEDING IN PERIMENOPAUSAL WOMEN: AN ANALYTICAL STUDY

Abstract

Background Abnormal uterine bleeding (AUB) is a condition that affects 9-14% of women between the ages of menarche and menopause. In India, the frequency of AUB is 17.9%, and it has a substantial effect on women of reproductive age. AUB accounts for 20% of gynecological consults and 25% of treatments. The 2011 PALM-COEIN classification standardized AUB causes into structural and non-structural categories. Obesity, linked to endometrial hyperplasia and cancer due to chronic anovulation and increased estrogen from adipose tissue, requires further study. Weight reduction can resolve AUB in obese women, emphasizing the need to examine BMI's impact on endometrial pathology in perimenopausal women to improve prevention, early detection, and treatment of endometrial carcinoma.

Materials and Methods A total of 62 perimenopausal women who had been diagnosed with irregular uterine bleeding and had been hospitalized to the department of Obstetrics and Gynaecology at R.L. Jalappa Hospital and Research Centre, Kolar participated in the current investigations. It was documented that pertinent facts such as age, parity, parental history of cancer, past history of malignancies, signs, and the length of time they lasted were all included. Physical examinations and baseline investigations were conducted, followed by endometrial biopsy for histopathological examination. Patients XXVI | Page

were divided into two groups: cases (BMI ≥ 25) and controls (BMI 18.5 - 24.99), to compare various parameters including menstrual cycle irregularities, endometrial thickness, and histopathological findings.

Results In this research, there were 62 perimenopausal women who had abnormal uterine bleeding. The participants were divided into two groups: 31 cases and 31 controls. Both groups had a similar mean age (~49.79 years) and height, but cases had higher mean weight (80.67 kg) and BMI (31.85 kg/m²) compared to controls (54.75 kg and 21.91 kg/m²). Cases experienced more severe menstrual irregularities, frequent cycles, heavier bleeding, and higher incidences of dysmenorrhea, diabetes, hypothyroidism, and OC pill usage. Biopsies showed more complex endometrial patterns and higher carcinoma rates in cases, with higher mean endometrial thickness (19.71 mm vs. 14.00 mm). Obese individuals had significantly thicker endometria than overweight ones.

Conclusion The study showed that perimenopausal women with higher BMI (≥25) had more severe menstrual irregularities, including frequent, prolonged cycles, heavier bleeding, and higher rates of abdominal pain, white discharge, diabetes, and hypothyroidism. Biopsies revealed more complex endometrial patterns and higher rates of hyperplasia and carcinoma.