Menstrual irregularity is frequently seen in women. However, if the interval between two periods is longer than 35 days, we interpret this situation as delayed periods. In other words, we consider a delay of up to one week as normal. However, if there is a delay of more than 1 week to 10 days between periods, we classify this condition as oligomenorrhea, which means delayed menstruation.
Periods can sometimes be delayed by 2-3 months; in fact, some women or young girls may experience the inability to menstruate without using medication. In such cases where menstruation is significantly delayed, a physician must evaluate the woman through examination, ultrasonography, and hormone tests to identify the cause, and then regulate the treatment to ensure the menstrual rhythm returns to normal.
If periods are delayed in a young girl or woman and there is accompanying excess weight, polycystic ovary disease should immediately come to mind. In polycystic ovary disease, problems such as menstrual delay, excess weight, increased hair growth, and infertility may coexist in varying degrees. If there is excess weight, metabolic problems such as insulin resistance and diabetes may also be present.
In polycystic ovary disease, there are numerous follicles—structures containing eggs—in the ovaries, but regular ovulation cannot occur. This ovulation problem is frequently caused by hormonal reasons and excess weight. Excess weight creates a vicious cycle, leading to further delays in menstruation. Accompanying insulin resistance also prevents weight loss, continuing the vicious cycle.
The goal in polycystic ovary patients is to break this vicious cycle. In other words, when we correct excess weight and insulin resistance, the ovulation problem may also disappear. The way to achieve this is through exercise and ensuring weight loss. In polycystic ovary patients, adopting calorie-restricted diets and exercise, such as walking three days a week, as a lifestyle will ensure the menstrual rhythm returns to normal.
One way to break insulin resistance in polycystic ovary patients is through medications containing metformin. These drugs are also given to diabetic patients. However, in polycystic ovary patients, metformin-containing drugs are administered to ensure hormonal balance. The use of these drugs can also accelerate weight loss by creating a loss of appetite.
In polycystic ovary patients, the aim should be to ensure that the body mass index falls below 25 kg/m2. By achieving this, periods can return to their normal rhythm, the ovulation problem can disappear, and spontaneous pregnancies can occur. Therefore, in polycystic ovary patients who also have trouble conceiving, the first goal should be to ensure weight loss and break insulin resistance to allow periods to return to normal. For this, it is necessary to implement a calorie-restricted diet and, most importantly, make exercise a lifestyle.
When menstrual irregularity and excess weight coexist, polycystic ovary disease should immediately come to mind. The first-line treatment for this disease is weight loss and exercise. It is necessary to adopt these principles for a healthy life in the long term for polycystic ovary patients.
