From the Guidelines
There is no clear evidence that bariatric surgery directly hastens menopause. While some women may experience changes in their menstrual cycles following bariatric surgery, these changes are typically related to the significant weight loss and metabolic improvements rather than early onset of menopause. The relationship between bariatric surgery and reproductive hormones is complex. Weight loss after surgery can actually improve hormone balance and fertility in many women who previously had irregular cycles due to obesity. Some women might experience temporary menstrual irregularities during the rapid weight loss phase, but this usually stabilizes over time.
Key points to consider:
- Nutritional deficiencies following bariatric surgery, particularly of iron, vitamin D, calcium, and B vitamins, could potentially affect hormonal function if not properly managed with appropriate supplementation 1.
- Women who undergo bariatric surgery should take prescribed supplements and have regular follow-up appointments to monitor nutritional status.
- If menstrual irregularities persist beyond the initial weight loss period, consultation with a gynecologist is recommended to rule out other causes unrelated to the surgery.
- A systematic review and meta-analysis found that bariatric surgery resulted in greater improvements in anthropometric outcomes compared to pharmacotherapy and lifestyle management in women with polycystic ovary syndrome (PCOS) 1.
- The evidence on the impact of bariatric surgery on reproductive outcomes in women with PCOS is limited and of poor quality, with high risk of bias demonstrated across all existing studies 1.
Overall, the current evidence suggests that bariatric surgery is not a direct cause of early menopause, but rather a potential tool for improving reproductive health outcomes in women with obesity and related conditions, such as PCOS. However, more research is needed to fully understand the effects of bariatric surgery on reproductive health and to inform evidence-based practice.
From the Research
Bariatric Surgery and Menopause
- The relationship between bariatric surgery and menopause is complex, with some studies suggesting that menopausal status can influence the efficacy of bariatric surgery 2.
- A study found that postmenopausal women had lower percentage of estimated weight loss (%EWL), total weight loss (TWL), percentage of total weight loss (%TWL), and change in body mass index (BMI) after bariatric surgery compared to premenopausal women 2.
- Another study found that women aged 20-45 years (presumptively premenopausal) had greater percent excess body weight loss (%EBWL) at 1 and 2 years post-surgery compared to women aged 55-65 years (presumptively postmenopausal) 3.
- The decline in estrogen levels during menopause can predispose women to the development of type 2 diabetes mellitus and obesity, which may be mitigated by bariatric surgery 2, 4.
- However, there is no direct evidence to suggest that bariatric surgery can hasten menopause, as the current research focuses on the effects of menopausal status on bariatric surgery outcomes rather than the impact of bariatric surgery on menopausal timing 5, 2, 3, 4, 6.
Weight Loss and Menopausal Status
- Weight loss after bariatric surgery is influenced by menopausal status, with premenopausal women tend to lose more weight than postmenopausal women 2, 3.
- The difference in weight loss between premenopausal and postmenopausal women may be due to age- or menopause-associated changes in physical activity, energy expenditure, or energy intake 3.
- Bariatric surgery can lead to significant weight loss and improvement in obesity-related comorbidities, regardless of menopausal status 6.