The Effect of Bariatric Surgery on Menstrual Abnormalities in Saudi Women: A Cross-Sectional Study

Lama Alhumaidan; Ghaday M Alrefaei; Abdulrahman M Alfantoukh; Amer S Alsaeri; Mohammed J Almuayrifi; Mohammed Alfehaid; Azzam S Al-Kadi

doi:10.7759/cureus.54964

The Effect of Bariatric Surgery on Menstrual Abnormalities in Saudi Women: A Cross-Sectional Study

Cureus. 2024 Feb 26;16(2):e54964. doi: 10.7759/cureus.54964. eCollection 2024 Feb.

Authors

Lama Alhumaidan¹, Ghaday M Alrefaei², Abdulrahman M Alfantoukh³, Amer S Alsaeri⁴, Mohammed J Almuayrifi⁵, Mohammed Alfehaid⁶, Azzam S Al-Kadi⁶

Affiliations

¹ College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU.
² College of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
³ College of Medicine, Imam Mohammad Ibn Saud University, Riyadh, SAU.
⁴ College of Medicine, Majmaah University, Al Majma'ah, SAU.
⁵ Surgery, Taibah University, Madinah, SAU.
⁶ Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU.

Abstract

Background: Adults in Saudi Arabia are more likely to be obese, which has negative effects on reproductive health, especially for women. While bariatric surgery (BS) provides a sustainable approach, little is known about how it affects menstrual health and requires a study among the Saudi demographic.

Methods: The current investigation is a cross-sectional study conducted in Saudi Arabia. Data were collected using an online questionnaire to assess the impact of BS on menstrual abnormalities in women. Data were cleaned in Excel and analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 24.0, Armonk, NY).

Results: This study included 516 Saudi women who underwent various BS procedures, with 37.2% aged 18-30 years and 97.9% residing in Saudi Arabia. Approximately 85.9% underwent sleeve gastrectomy (SG), experiencing a mean weight loss of 54.2 kg. Co-morbidities included polycystic ovary syndrome (PCOS) (12.4%), hypothyroidism or hyperthyroidism (11%), uterine fibroids (4.7%), and hormonal imbalances (2.5%). Post-surgery, 18% encountered BS complications from BS, while 8.3% used antidepressants. Moderate sports participation ranged from 12.2% (five or more days) to 36.2% (one to three days). In particular, no significant associations were found between complications and various parameters, except a marginal association with educational level (p=0.071). The number of menstruations per year did not change statistically significantly, remaining constant at 10.6±4.8 before surgery and 10.6±4.9 after surgery (p = 0.859). However, there was a mild decrease in the amount and duration of menstruation, reported by 23.3% and 27.3% of the participants preoperatively and post-operatively, respectively.

Conclusion: The study demonstrates the impact of BS on menstrual abnormalities in Saudi women. Despite a significant weight reduction, we found mild improvement in the amount and duration of menstruation with no substantial effect observed on the menstrual cycle frequency. Psychological support after surgery is crucial, considering the increased use of antidepressants.

Keywords: bariatric surgery; hormonal imbalance; menstrual abnormalities; obesity; pcos; uterine fibroids.