The Relation between Body Mass Index and Menstrual Cycle Disorders in Medical Students of University Pelita Harapan, Indonesia

Authors: Gabriella Tjondro, Julita Dortua Laurentina Nainggolan

Abstract:

Introduction: There are several things affecting menstrual cycle, namely, nutritional status, diet, financial status of one’s household and exercises. The most commonly used parameter to calculate the fat in a human body is body mass index. Therefore, it is necessary to do research to prevent complications caused by menstrual disorder in the future. Design Study: This research is an observational analytical study with the cross-sectional-case control approach. Participants (n = 124; median age = 19.5 years ± SD 3.5) were classified into 2 groups: normal, NM (n = 62; BMI = 18-23 kg/m²) and obese, OB (n = 62; BMI = > 25 kg/m²). BMI was calculated from the equation; BMI = weight, kg/height, m². Results: There were 79.10% from obese group who experienced menstrual cycle disorders (n=53, 79.10%; p value 0.00; OR 5.25) and 20.90% from normal BMI group with menstrual cycle disorders. There were several factors in this research that also influence the menstrual cycle disorders such as stress (44.78%; p value 0.00; OR 1.85), sleep disorders (25.37%; p value 0.00; OR 1.01), physical activities (25.37%; p value 0.00; OR 1.24) and diet (10.45%; p value 0.00; OR 1.07). Conclusion: There is a significant relation between body mass index (obese) and menstrual cycle disorders. However, BMI is not the only factor that affects the menstrual cycle disorders. There are several factors that also can affect menstrual cycle disorders, in this study we use stress, sleep disorders, physical activities and diet, in which none of them are dominant.

Keywords: Menstrual disorders, menstrual cycle, obesity, body mass index, stress, sleep disorders, physical activities, diet.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.2571849

References:

[1] Wiknjosastro. Anatomi dan Fisiologi Alat-Alat Reproduksi Dalam:Ilmu Kebidanan Edition 3. 2009.
[2] Ganong, William F., et al. Ganong's Review of Medical Physiology. 24th ed. New York, N. Y.: McGraw Hill Medical, 2012.
[3] Cunningham, F. Gary, et al. Williams Obstetrics. 24th edition. New York: McGraw-Hill Education, 2014.
[4] Setiawati, SE. Pengaruh stres terhadap siklus menstruasi pada remaja. Universitas Lampung. 2015; 4: 94–8.
[5] Johnson SR. Premenstrual Syndrome, Premenstrual Dysphoric Disorder, and Beyond: A Clinical Primer for Practitioners. America. 2004; 104(4): 845–59.
[6] Agrawal P, Gupta K, Mishra V, Agrawal S. 2014. A study on body-weight perception, future intention and weight-management behaviour among normal-weight, overweight and obese women in India. Public Health Nutrition. 17: 884–95.
[7] Adnyani NKW, Ni Nyoman Gunahariati NG a T. Hubungan Status Gizi dengan Siklus Menstruasi pada Remaja Putri Kelas X di SMA PGRI 4 Denpasar. Gangguan menstruasi. 2018; 1(1).
[8] Graham M, James EL, Keleher H. Predictors of Hysterectomy as a Treatment for Menstrual Symptoms. Women’s Heal Issues. 2018; 18(4): 319–27.
[9] Solomon CG, Hu FB, Dunaif A, Rich-Edwards JE, Stampfer MJ, Willett WC, et al. Menstrual cycle irregularity and risk for future cardiovascular disease. J Clin Endocrinol Metab. 2015; 87(5): 2013–7.
[10] Kang H, Chen YM, Han G, Huang H, Chen WQ, Wang X, et al. Associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women: A cross-sectional study. Int J Environ Res Public Health. 2016; 13(2).
[11] Rowland AS, Baird DD, Long S, Wegienka G, Harlow SD, Alavanja M, et al. Influence of medical conditions and lifestyle factors on the menstrual cycle. Epidemiology. 2017; 13(6): 668–74.
[12] Behel A. Diet And Body Composition Submitted by Ms. Amrita Behel. Diet Body Compos AS Determ MENARCHE. 2014.
[13] International Diabetes Institute/ Western Pacific World Health Organization/ International, Force A for the study of OIOT. The Asia-Pacific perspective: redefining obesity and its treatment. Geneva, Switzerland: World Health Organization. 2015. p. 56.
[14] Kemenkes. Standar Antropometri Penilaian Status Gizi Anak. 2010. p. 40.
[15] Waryana. Gizi Reproduksi. Yogyakarta: Pustaka Rahima; 2010.
[16] Ekpenyong, C. E., Davis, K. J., Akpan, U. P., & Daniel, N. E. Academic stress and menstrual disorders among female undergraduates in Uyo, South Eastern Nigeria - the need for health education. Nig. J. Physiol. 2011. Sci, 26, 193-198.
[17] Bakker, F.C., Kahan, T, L., Trinder, J. dan Colrain, I. M. Sleep Quality and The Sleep Electroencephalogram in Women with Severe Premenstrual Syndrome of Journal. 2007. Sleep, 30, 1283-1291
[18] Keizer HA, Rogol AD. Physical Exercise and Menstrual Cycle Alterations. Sport Med. Virginia USA. 1990; 10(4): 218–35.
[19] Barr SI, Janelle KC, Prior JC. Vegetarian vs nonvegetarian diets, dietary restraint, and subclinical ovulatory disturbances: prospective 6-mo study. Am J Clin Nutr 1994; 60: 887–94.
[20] Teixeira A, Oliveira E,and Dias M:Relationship between the level of physical activity and premenstrual syndrome incidence. Rev Bras Ginecol Obstet. 2013 May; 35(5): 210-4.
[21] Critchley H, Lumsden M, Campbell-Brown M, Douglas A, and Murray G. Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data. Am J Obstet Gynecol. 2014; 190: 1216 –1223. 

[22] Sherwood, L. 2012. Fisiologi Manusia dari Sel ke Sistem. Edisi 6. Jakarta: EGC. h. 708-710.
[23] Kusmiran, Eny. 2011. Reproduksi Remaja dan Wanita. Jakarta: Salemba Medika.
[24] Tortora G, Derrickson B. Principles of Anatomy & Physiology. Igarss 2014. 1-1347 p.
[25] Blundell JE, Caudwell P, Gibbons C, Hopkins M, Näslund E, King NA, et al. Body composition and appetite: fat-free mass (but not fat mass or BMI) is positively associated with self-determined meal size and daily energy intake in humans. Br J Nutr. 2013; 107(3): 445–9.
[26] Beals KA. Eating behaviors, nutritional status, and menstrual function in elite female adolescent volleyball players. Vol. 102, Journal of the American Dietetic Association. 2014. p. 1293–6.
[27] Aladashvili-Chikvaidze, Nutsa, Kristesashvil, J., Gegechko, M., 2015. Types of reproductive disorders in underweight and overweight young females and correlations of respective hormonal changes with BMI. Iran J Reprod Med, 13(3): 135-140.
[28] Setiawati, S. E., 2015. Pengaruh Stres Terhadap Siklus Menstruasi. J Majority, 4(1): 94-98.
[29] Barde, Sheetal., Sheela, Upendra., Seeta Devi., 2015. Influence of Body Mass Index on Menstrual Irregularities in Adolescent girls. Int J Med Health Sci, 4(2).
[30] Bassi, R., Sharma, S., Saini, A.S., Kaur, M., 2015. Correlation of Menstrual Pattern with Body Mass Index in Young Female Students. J Phys Pharm Adv, 5(2): 556-564.
[31] Fujiwara T. The discrepancy between BMI and self- recognition of adequate body weight may cause insufficient food intake and habits in young women in Japan. Bulletin of Ashiya 
College; 2015. 27: 75-80.
[32] Krassas GE, Pontikides N, Kaltsas T, Papadopoulou P, Paunkovic J, Paunkovic N, et al. Disturbances of menstruation in hypothyroidism. Clin Endocrinol (Oxf). 2013; 50(5): 655–9.
[33] Dars S, Sayed K, Yousufzai Z. Relationship of menstrual irregularities to BMI and nutritional status in adolescent girls. Vol. 30, Pakistan Journal of Medical Sciences. 2014. p. 140–4.
[34] Kakisina, P., & Indra, R., 2008, Peran Leptin Terhadap Aktivitas Maturation- Promoting Factor (MPF) Pada Maturasi Oosit, Jurnal kedokteran Brawijaya, 24, 36-43.
[35] Islami. Hubungan Obesitas dengan Siklus Menstruasi pada Wanita Usia Subur di desa Kaliwungu desa Kedungdowo Kecamatan Kaliwungu Kabupaten Kudus tahun 2016. 2016; 1(1).