Working as an obstetrician and anti-aging medicine doctor under the concept of “Women Wellness” at Smart Life Anti-Aging Center, I have found that obesity is not only related to hormonal changes but is also a contributing factor in gynecological diseases, including cancer.
Female hormones and fat accumulation
Many studies discuss the shape of obese women, which is associated with hormonal abnormalities and disease occurrence. It has been found that women with a “pear-shaped” body, who accumulate fat mainly around the hips and thighs, are associated with a high proportion of estrogen levels. Many experience irregular menstruation or symptoms in the PMS group, which show abnormal symptoms before menstruation such as swelling of the body, facial swelling, irritability, headaches, etc.
On the other hand, women with an “apple-shaped” body or abdominal obesity are associated with metabolic syndrome because the fat accumulated around the internal organs in the abdominal cavity, or visceral fat, affects abnormal metabolism and leads to diabetes, hypertension, and cardiovascular diseases.
A study published in the European Heart Journal found that women with an “apple-shaped” body have a three times higher risk of cardiovascular disease than those with a pear shape. Additionally, they also experience irregular menstruation, oily skin, acne, hair loss, or PCOS symptoms, which involve abnormally high levels of male hormones causing anovulation, irregular menstruation, and increased chances of infertility.
It has also been found that obesity increases the risk of cancer, including colon cancer, kidney cancer, ovarian cancer, and importantly, breast cancer and endometrial cancer, which are related to stimulation by estrogen, especially in menopausal or postmenopausal women.
Estrogen hormone can be produced by fat tissue cells
We know that estrogen is the main female hormone primarily produced by the ovaries. Other sources include the adrenal glands and fat tissue. When entering menopause, although the ovaries stop functioning and no longer produce estrogen, production continues from cells in fat tissue. Therefore, obese women have a significant source of estrogen from fat tissue. Many studies have found estrogen-sensitive cancers in obese menopausal women. For example, obese women (BMI>25) have a 1.5 times higher risk of breast cancer compared to women with normal weight because 80% of breast cancers are related to estrogen stimulation. Obese women also have a 2-4 times higher risk of endometrial cancer compared to women with normal weight because endometrial cancer includes types stimulated by estrogen, starting with abnormal thickening of the endometrium and abnormal cellular changes leading to cancer.
Sometimes, patients in this group have hormonal problems even before menopause, all related to obesity, and some who do not manage it properly develop cancer at a young age…
“I have a case example of a foreign patient, a 15-year-old girl who came with amenorrhea. Her mother brought her for examination. She weighed 100 kg and was diagnosed with PCOS. I recommended weight loss and prescribed medication to restore normal menstruation, along with a diet and exercise program. Unfortunately, she lost contact and never returned for treatment.
She came back at age 22 with heavy vaginal bleeding causing fatigue, needing up to 10 sanitary pads per day. Ultrasound showed severely thickened endometrium, requiring dilation and curettage for diagnosis and treatment. The result was… endometrial cancer at only 22 years old, necessitating urgent hysterectomy. It is regrettable because if she had cooperated with the doctor to lose weight and normalize her menstruation, the chance of cancer would have been almost zero.”
Dr. Thisara Weerasamai
Obstetrics and Gynecology Specialist
Women’s Health Center, Phyathai 1 Hospital
