Abstract
BACKGROUND: Obesity is a rising global health issue, especially among women, with important effects on reproductive health. This problem is becoming more urgent in Asia, reflecting worldwide trends in increasing rates. Despite expanding evidence, integrated guidance remains limited. This narrative clinical review synthesizes current evidence to provide practical clinical recommendations. METHODS: This was a narrative clinical review informed by expert opinion and developed by the Thai Interest Group in Obesity and Female Reproductive Health through an interdisciplinary collaborative process. The approach included a comprehensive literature review across various databases to gather high-quality scientific evidence, clinical guidelines, and epidemiological data on the connection between obesity and female reproductive health. RESULTS: The review summarizes current evidence on how obesity affects key reproductive conditions, including polycystic ovary syndrome (PCOS), infertility, and menopause. Obesity is strongly associated with PCOS, contributing to hormonal imbalances, insulin resistance, and metabolic dysfunction. It also impacts fertility by disrupting ovarian function and increasing the risk of pregnancy complications. Furthermore, menopausal women with obesity face higher risks of cardiovascular disease, metabolic disorders, and severe menopausal symptoms due to increased visceral adiposity and hormonal changes. Evidence supports the role of weight management, including lifestyle changes and pharmacological interventions, in improving reproductive outcomes. Weight reduction has been shown to improve ovulation, menstrual regularity, and fertility in women with PCOS and obesity. Anti-obesity drugs have proven effective for weight loss and enhancing reproductive health. CONCLUSION: Obesity has significant negative effects on female reproductive health from adolescence to menopause but these issues can be reversed with effective weight management. With the increasing rate of obesity in Asia, healthcare professionals must prioritize weight management strategies to mitigate its harmful impact on women's reproductive health.