Peculiarities of sexual development and reproductive function in young women with childhood onset weight problems.

The risks of reproductive problems are higher in underweight and overweight or obese women, especially in case of rapid weight gain or loss. But evidence is inconsistent especially in relation to the effect of age of body weight changes. The aim of the study was detection of peculiarities of sexual development and reproductive function in underweight and overweight/obese females with childhood thinness or childhood obesity. 103 young females (48 - with low BMI, 55 - with high BMI) with different reproductive problems were examined prospectively. In all investigated patients full clinical examination was held, including body mass index (BMI), type of body fat distribution (waist-to-hip ratio), age of body weight changes, assessment of hirsutism, acne, stretch marks and hyperpigmentation, menstrual disturbances and fertility problems were recorded and gynecological ultrasound was performed. There was no difference established according to the age of menarche and types of menstrual disturbances between the groups of low BMI and high BMI females (p>.05). The correlation was established between the onset of menstrual disruption and progression of changes in body mass (R=.448, p=.005). Hirsutism, stretch marks and acantosis nigricans (hyperpigmentation) were exhibited significantly more frequently in the patients with high BMI (p<.05), whilst distribution of acne was almost the same in the study groups (p>.05). 74.5% of overweight and obese patients had upper body fat distribution (waist-to-hip ratio > 0.8), whilst underweight patients had mostly equal (66.7%) or lower body fat distribution (31.3%) (p=.000). Polycystic ovarian syndrome (PCOS) and metabolic syndrome (MS) was the most frequent in overweight and obese patients, whilst non-classical congenital adrenal hyperplasia (NCAH) and ovarian dysfunction prevailed in the underweight females (p<.05). Infertility was mostly observed in patients with high BMI (p<.05). In conclusion, the peculiarities of sexual development and menstrual function in young females with childhood thinness and obesity are related to their reproductive disorders, childhood BMI and progression of BMI changes.