Weight loss leads to reduced fat mass, reduced oestrogen metabolism, and amenorrhoea. Energy deficiency may play a key role in the pathogenesis (1).
The effects of weight loss on menstruation may be estimated from the Ponteral index which is defined as: Weight in Kg / (Height in Metres, squared)
A ponteral index less than 17 or greater than 25 - 27 predicts amenorrhoea. The range of values at the upper limit arises from the greater unpredictability of obesity on menstruation, except in cases of the polycystic ovarian syndrome.
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