Social Studies

A Cross-Sectional Study of the Relationship Between BMI and Menstrual Cycle Regularity in Women of Reproductive Age in Pamekasan

Download
PDF
Published
27-07-2025
Pages
129-141

Abstract

Obesity is increasingly recognized as a significant determinant of women’s reproductive health, particularly in relation to menstrual cycle irregularities. This cross-sectional study aimed to examine the relationship between Body Mass Index (BMI) and menstrual cycle regularity among women of reproductive age in Pamekasan, Indonesia. A total of 113 respondents aged 18–45 years were selected through simple random sampling. BMI data were obtained through anthropometric measurements, while menstrual cycle patterns were assessed using structured questionnaires. The study identified a notable trend: the likelihood of menstrual disturbances increased with higher BMI classifications. Women classified as overweight and obese experienced a higher prevalence of irregular menstrual cycles compared to those with normal BMI. These findings highlight the potential influence of excess body weight on hormonal regulation and ovulatory function. In rural settings like Pamekasan, where the prevalence of obesity is rising, this study emphasizes the need to integrate weight management into reproductive health programs. Targeted interventions through community education, nutritional counseling, and primary care integration could play a vital role in improving reproductive outcomes and reducing the burden of menstrual disorders.
Keywords: body mass index menstrual cycle regularity obesity pamekasan reproductive health rural context women of reproductive age

References

  1. Al Sabbah, H. (2020). Prevalence of overweight/obesity, anaemia and their associations among female university students in Dubai, United Arab Emirates: A cross-sectional study. Journal of Nutritional Science, 9, e26. https://doi.org/10.1017/jns.2020.23
  2. Angelidis, G., Dafopoulos, K., Messini, C. I., Valotassiou, V., Tsikouras, P., Vrachnis, N., Psimadas, D., Georgoulias, P., & Messinis, I. E. (2013). The Emerging Roles of Adiponectin in Female Reproductive System-Associated Disorders and Pregnancy. Reproductive Sciences, 20(8), 872–881. https://doi.org/10.1177/1933719112468954
  3. Baker, J. M., Al-Nakkash, L., & Herbst-Kralovetz, M. M. (2017). Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas, 103, 45–53. https://doi.org/10.1016/j.maturitas.2017.06.025
  4. Bull, J. R., Rowland, S. P., Scherwitzl, E. B., Scherwitzl, R., Danielsson, K. G., & Harper, J. (2019). Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. Npj Digital Medicine, 2(1), 83. https://doi.org/10.1038/s41746-019-0152-7
  5. Chen, X., Xi, H., Ji, L., Liu, W., Shi, F., Chen, Y., Wang, X., Zhang, W., Sui, X., Wang, X., Zhang, H., Liu, H., & Li, D. (2020). Relationships between menstrual status and obesity phenotypes in women: A cross-sectional study in northern China. BMC Endocrine Disorders, 20(1), 91. https://doi.org/10.1186/s12902-020-00577-6
  6. Chong, B., Jayabaskaran, J., Kong, G., Chan, Y. H., Chin, Y. H., Goh, R., Kannan, S., Ng, C. H., Loong, S., Kueh, M. T. W., Lin, C., Anand, V. V., Lee, E. C. Z., Chew, H. S. J., Tan, D. J. H., Chan, K. E., Wang, J.-W., Muthiah, M., Dimitriadis, G. K., … Chew, N. W. S. (2023). Trends and predictions of malnutrition and obesity in 204 countries and territories: An analysis of the Global Burden of Disease Study 2019. eClinicalMedicine, 57, 101850. https://doi.org/10.1016/j.eclinm.2023.101850
  7. Cwikel, J., Gidron, Y., & Sheiner, E. (2004). Psychological interactions with infertility among women. European Journal of Obstetrics & Gynecology and Reproductive Biology, 117(2), 126–131. https://doi.org/10.1016/j.ejogrb.2004.05.004
  8. Dhawan, V., & Dada, R. (2020). Yoga, Meditation, and Acupuncture for Male Reproductive Health. In S. J. Parekattil, S. C. Esteves, & A. Agarwal (Eds.), Male Infertility: Contemporary Clinical Approaches, Andrology, ART and Antioxidants (pp. 593–602). Springer International Publishing. https://doi.org/10.1007/978-3-030-32300-4_48
  9. Doubova, S. V., Infante-Castañeda, C., Espinosa-Alarcón, P., Flores-Hernández, S., Martinez-Vega, I., & Pérez-Cuevas, R. (2013). Effectiveness of an integrative health-care model for climacteric-stage women. Climacteric, 16(5), 590–600. https://doi.org/10.3109/13697137.2012.720621
  10. Ferin, M. (1999). Stress and the Reproductive Cycle. The Journal of Clinical Endocrinology & Metabolism, 84(6), 1768–1774. https://doi.org/10.1210/jcem.84.6.5367
  11. Global Nutritio. (2020). 2020 Global Nutrition Report—Global Nutrition Report. https://globalnutritionreport.org/reports/2020-global-nutrition-report/
  12. Guo, C., & Zhang, C. (2024). Role of the gut microbiota in the pathogenesis of endometriosis: A review. Frontiers in Microbiology, 15, 1363455. https://doi.org/10.3389/fmicb.2024.1363455
  13. Hashim, M. S., Obaideen, A. A., Jahrami, H. A., Radwan, H., Hamad, H. J., Owais, A. A., Alardah, L. G., Qiblawi, S., Al-Yateem, N., & Faris, “Mo’ez Al-Islam” E. (2019). Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE. Nutrients, 11(8), 1939. https://doi.org/10.3390/nu11081939
  14. Jenabi, E., Khazaei, S., & Veisani, Y. (2019). The association between body mass index and the risk of endometriosis: A meta-analysis. Journal of Endometriosis and Pelvic Pain Disorders, 11(2), 55–61. https://doi.org/10.1177/2284026519832814
  15. Jiang, X.-Y., Zheng, L., Xiong, M., Wang, S.-L., Jin, Q.-Q., Yang, Y.-T., Fang, Y.-X., Hong, L., Mei, J., & Zhou, S.-G. (2024). Body Mass Index and Risk of Female Reproductive System Tumors Subtypes: A Meta-Analysis Using Mendelian Randomization. Technology in Cancer Research & Treatment, 23, 15330338241277699. https://doi.org/10.1177/15330338241277699
  16. Khan, M. J., Ullah, A., & Basit, S. (2019). Genetic basis of polycystic ovary syndrome (PCOS): Current perspectives. The Application of Clinical Genetics, 249–260.
  17. Kraemer, W. J., & Ratamess, N. A. (2005). Hormonal Responses and Adaptations to Resistance Exercise and Training: Sports Medicine, 35(4), 339–361. https://doi.org/10.2165/00007256-200535040-00004
  18. Loucks, A. B., & Thuma, J. R. (2003). Luteinizing Hormone Pulsatility Is Disrupted at a Threshold of Energy Availability in Regularly Menstruating Women. The Journal of Clinical Endocrinology & Metabolism, 88(1), 297–311. https://doi.org/10.1210/jc.2002-020369
  19. McGee, W. K., Bishop, C. V., Pohl, C. R., Chang, R. J., Marshall, J. C., Pau, F. K., Stouffer, R. L., & Cameron, J. L. (2014). Effects of hyperandrogenemia and increased adiposity on reproductive and metabolic parameters in young adult female monkeys. American Journal of Physiology-Endocrinology and Metabolism, 306(11), E1292–E1304. https://doi.org/10.1152/ajpendo.00310.2013
  20. Meherali, S., Hussain, A., Rahim, K. A., Idrees, S., Bhaumik, S., Kennedy, M., & Lassi, Z. S. (2024). Digital knowledge translation tools for sexual and reproductive health information to adolescents: An evidence gap-map. Therapeutic Advances in Reproductive Health, 18, 26334941241307881. https://doi.org/10.1177/26334941241307881
  21. Moran, L. J., Tassone, E. C., Boyle, J., Brennan, L., Harrison, C. L., Hirschberg, A. L., Lim, S., Marsh, K., Misso, M. L., Redman, L., Thondan, M., Wijeyaratne, C., Garad, R., Stepto, N. K., & Teede, H. J. (2020). Evidence summaries and recommendations from the international evidence‐based guideline for the assessment and management of polycystic ovary syndrome: Lifestyle management. Obesity Reviews, 21(10), e13046. https://doi.org/10.1111/obr.13046
  22. Motsinger, S., Lazovich, D., MacLehose, R. F., Torkelson, C. J., & Robien, K. (2012). Vitamin D intake and mental health-related quality of life in older women: The Iowa Women’s Health Study. Maturitas, 71(3), 267–273. https://doi.org/10.1016/j.maturitas.2011.12.005
  23. Munro, M. G., Critchley, H. O. D., Fraser, I. S., & the FIGO Menstrual Disorders Committee. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. International Journal of Gynecology & Obstetrics, 143(3), 393–408. https://doi.org/10.1002/ijgo.12666
  24. Mykhalchenko, K., Lizneva, D., Trofimova, T., Walker, W., Suturina, L., Diamond, M. P., & Azziz, R. (2017). Genetics of polycystic ovary syndrome. Expert Review of Molecular Diagnostics, 17(7), 723–733. https://doi.org/10.1080/14737159.2017.1340833
  25. Nakamura, K., Sheps, S., & Clara Arck, P. (2008). Stress and reproductive failure: Past notions, present insights and future directions. Journal of Assisted Reproduction and Genetics, 25(2–3), 47–62. https://doi.org/10.1007/s10815-008-9206-5
  26. Octaria, Y., Khomsan, A., Tanziha, I., & Sukandar, D. (2020). Prevalence and Determinants for Hypertension among Rural Women of Reproductive Age in Indonesia. Jurnal Gizi Dan Pangan, 15(2), 71–80. https://doi.org/10.25182/jgp.2020.15.2.71-80
  27. Pasquali, R., & Gambineri, A. (2006). Metabolic effects of obesity on reproduction. Reproductive BioMedicine Online, 12(5), 542–551. https://doi.org/10.1016/S1472-6483(10)61179-0
  28. Pasquali, R., Gambineri, A., & Pagotto, U. (2006). Review article: The impact of obesity on reproduction in women with polycystic ovary syndrome. BJOG: An International Journal of Obstetrics & Gynaecology, 113(10), 1148–1159. https://doi.org/10.1111/j.1471-0528.2006.00990.x
  29. Peña, A. S., Witchel, S. F., Hoeger, K. M., Oberfield, S. E., Vogiatzi, M. G., Misso, M., Garad, R., Dabadghao, P., & Teede, H. (2020). Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Medicine, 18(1), 72. https://doi.org/10.1186/s12916-020-01516-x
  30. Popkin, B. M., Corvalan, C., & Grummer-Strawn, L. M. (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet, 395(10217), 65–74. https://doi.org/10.1016/S0140-6736(19)32497-3
  31. Rokom. (2024). Sering Dianggap Menggemaskan, Obesitas Membahayakan Masa Depan Anak. https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20240306/1545063/sering-dianggap-menggemaskan-obesitas-membahayakan-masa-depan-anak/
  32. Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.-B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health, 2(6), e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X
  33. Schoenaker, D. A., Jackson, C. A., Rowlands, J. V., & Mishra, G. D. (2014). Socioeconomic position, lifestyle factors and age at natural menopause: A systematic review and meta-analyses of studies across six continents. International Journal of Epidemiology, 43(5), 1542–1562. https://doi.org/10.1093/ije/dyu094
  34. Shirley, M. K., Longman, D. P., Elliott-Sale, K. J., Hackney, A. C., Sale, C., & Dolan, E. (2022). A Life History Perspective on Athletes with Low Energy Availability. Sports Medicine, 52(6), 1223–1234. https://doi.org/10.1007/s40279-022-01643-w
  35. Soca Daru Indraswari. (2025). Legal Implications of Insurance Supervisor’s Liability in Policy Failure: Implikasi Hukum atas Tanggung Jawab Pengawas Asuransi dalam Kegagalan Polis. Peradaban Hukum Nusantara, 1(2), 122–142. https://doi.org/10.62193/gzcvc287
  36. Sridhar, A., Khan, D., & Moffett, R. C. (2023). The impact of diabetes and obesity on fertility and the potential role of gut hormones as treatment. Diabetic Medicine, 40(12), e15230. https://doi.org/10.1111/dme.15230
  37. Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly, 83(3), 457–502. https://doi.org/10.1111/j.1468-0009.2005.00409.x
  38. Subramanian, A., & Gernand, A. D. (2019). Vitamin D metabolites across the menstrual cycle: A systematic review. BMC Women’s Health, 19(1), 19. https://doi.org/10.1186/s12905-019-0721-6
  39. Vigil, P., Lyon, C., Flores, B., Rioseco, H., & Serrano, F. (2017). Ovulation, A Sign of Health. The Linacre Quarterly, 84(4), 343–355. https://doi.org/10.1080/00243639.2017.1394053
  40. Wang, Y.-X., Arvizu, M., Rich-Edwards, J. W., Stuart, J. J., Manson, J. E., Missmer, S. A., Pan, A., & Chavarro, J. E. (2020). Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: Prospective cohort study. BMJ, m3464. https://doi.org/10.1136/bmj.m3464
  41. Wei, S., Schmidt, M. D., Dwyer, T., Norman, R. J., & Venn, A. J. (2009). Obesity and Menstrual Irregularity: Associations With SHBG, Testosterone, and Insulin. Obesity, 17(5), 1070–1076. https://doi.org/10.1038/oby.2008.641
  42. WHO. (2024). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  43. World Health Organization (WHO). (2000). International Association for the Study of Obesity (IASO), International Obesity Task Force (IOTF)(2000). The Asia–Pacific Perspective: Redefining Obesity and Its Treatment. Geneva: World Health Organization.
  44. Zhou, X., & Yang, X. (2020). Association between obesity and oligomenorrhea or irregular menstruation in Chinese women of childbearing age: A cross-sectional study. Gynecological Endocrinology, 36(12), 1101–1105. https://doi.org/10.1080/09513590.2020.1803823

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 Ratna Hermawati, Dewangga Wahyu Praja, Khoirul Umam

Authors who publish with this journal agree to the following terms:

  • Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

Indexing & Citations

How to Cite

Hermawati, R. ., Praja, D. W. ., & Umam, K. . (2025). A Cross-Sectional Study of the Relationship Between BMI and Menstrual Cycle Regularity in Women of Reproductive Age in Pamekasan. Ascarya: Journal of Islamic Science, Culture, and Social Studies, 5(1), 129-141. https://doi.org/10.53754/4jtssc51

Similar Articles

41-46 of 46

You may also start an advanced similarity search for this article.