Hyperinsulinemia Linked to Abnormal Uterine Bleeding
TUESDAY, June 10, 2025 -- In premenopausal women, hyperinsulinemia is associated with abnormal uterine bleeding (AUB), with body mass index (BMI) playing a role in this association, according to a study published online June 3 in Menopause.
Andrea C. Salcedo, D.O., M.P.H., from Loma Linda University School of Medicine in California, and colleagues conducted a cross-sectional study from June 2019 to August 2023 at a single institution's outpatient gynecology clinic involving 205 premenopausal women aged 18 to 54 years: 116 with AUB and 89 with normal menstrual cycles. Participants underwent fasting insulin assessment, with additional markers of metabolic syndrome. The association between hyperinsulinemia and AUB was examined, adjusting for confounders.
The researchers found that hyperinsulinemia significantly predicted AUB (odds ratio, 3.009). The significance of hyperinsulinemia was attenuated with inclusion of BMI in the model, suggesting overlapping or mediating pathways. Seventy-three percent concordance and improved model fit was achieved with the final model, which included age, low-density lipoprotein, and waist-to-hip ratio.
"These preliminary findings highlight the need for larger, longitudinal studies to confirm these relationships, identify causal mechanisms, and evaluate the potential of addressing hyperinsulinemia, being overweight, and obesity as part of prevention and treatment strategies for abnormal uterine bleeding," Stephanie Faubion, M.D., medical director of The Menopause Society, said in a statement.
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