Universitas Muhammadiyah Sidoarjo
Login


Indonesian Journal on Health Science and Medicine

 Submit manuscript
Section Articles

Prevalence of Obesity in Women of Childbearing Age with Polycystic Ovary Syndrome: Jordanian Royal Medical Services Context

Vol. 2 No. 3 (2025): Desember:
DOI : https://doi.org/10.21070/ijhsm.v2i3.323
Published : Dec 14, 2025

Ahmad Ibraheem Eissa Al-Bataineh (1), Hamza Ali Faisal Al-Tahat (2), Qussai Omar Al-Boqai (3), Taleb Atiyah Taleb Al-Zoubi (4), Mohammad Yousef Ali Al-Tahat (5)

(1) Department of Obstetrics and Gynecology, Prince Rashid Ben Al-Hasan Military Hospital, Jordan
(2) Department of Obstetrics and Gynecology, King Talal Military Hospital, Jordanian Royal Medical Services, Jordan
(3) Department of Obstetrics and Gynecology, King Talal Military Hospital, Jordanian Royal Medical Services, Jordan
(4) Department of Obstetrics and Gynecology, Prince Rashid Ben Al-Hasan Military Hospital, Jordanian Royal Medical Services, Jordan
(5) Department of Obstetrics and Gynecology, Prince Rashid Ben Al-Hasan Military Hospital, Jordanian Royal Medical Services, Jordan
Fulltext View | Download

Abstract:

Polycystic ovary syndrome (PCOS) represents a significant public health challenge among women of reproductive age in Jordan. The structured environment of military medicine presents unique opportunities for targeted healthcare interventions. Despite growing concern over rising obesity rates, limited data exist on how obesity severity influences PCOS-related metabolic and reproductive outcomes in this demographic. This study aimed to examine the prevalence of obesity and its clinical impact on metabolic and reproductive parameters among Jordanian women diagnosed with PCOS within a military healthcare setting. It further sought to identify obesity-related thresholds linked to adverse clinical outcomes. A retrospective study was conducted on 50 women with PCOS receiving care at Princess Haya Military Hospital under the Royal Medical Services between 2023–2024. Participants were stratified based on the World Health Organization (WHO) body mass index (BMI) classifications. Clinical variables, including insulin resistance (HOMA-IR), testosterone levels, menstrual irregularities, and infertility rates, were assessed across BMI categories. The analysis revealed that 72% of participants (n=36) had a BMI ≥30, with 24% (n=12) meeting criteria for severe obesity (BMI ≥35). A clear dose-response relationship was observed between increasing BMI and adverse clinical markers. Women with obesity class III exhibited a 2.4-fold higher HOMA-IR (4.3±1.2 vs 1.8±0.5 in normal-weight women, p<0.001) and 4.8-fold higher odds of infertility (95% CI: 1.42–16.2). Testosterone levels increased progressively by 63.5% from normal to obese groups (p=0.003). A BMI ≥35 was associated with 82% of patients presenting both oligomenorrhea and clinical signs of insulin resistance.


Highlights



  1. Obesity affected 72% of Jordanian women with PCOS treated in a military healthcare setting.

  2. Increasing BMI showed a clear dose–response relationship with insulin resistance and hyperandrogenism.

  3. Women with BMI ≥35 had markedly higher risks of infertility, oligomenorrhea, and metabolic dysfunction.

References

[1] Boutari, Chrysoula, and Christos S. Mantzoros. “A 2022 Update on the Epidemiology of Obesity and a Call to Action: As Its Twin COVID-19 Pandemic Appears to Be Receding, the Obesity and Dysmetabolism Pandemic Continues to Rage On.” Metabolism, vol. 133, no. 155217, 15 May 2022, p. 155217, pmc.ncbi.nlm.nih.gov/articles/PMC9107388/, https://doi.org/10.1016/j.metabol.2022.155217.

[2] Alfaris, Nasreen, et al. “Global Impact of Obesity.” Gastroenterology Clinics of North America, vol. 52, no. 2, Apr. 2023, https://doi.org/10.1016/j.gtc.2023.03.002.

[3] Al-Jawaldeh, Ayoub, and Marwa M. S. Abbass. “Unhealthy Dietary Habits and Obesity: The Major Risk Factors beyond Non-Communicable Diseases in the Eastern Mediterranean Region.” Frontiers in Nutrition, vol. 9, no. 2, 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC8970016/, https://doi.org/10.3389/fnut.2022.817808.

[4] Zheng, Lei, et al. “Obesity and Its Impact on Female Reproductive Health: Unraveling the Connections.” Frontiers in Endocrinology, vol. 14, no. 1326546, 9 Jan. 2024, https://doi.org/10.3389/fendo.2023.1326546.

[5] Joham, Anju E, et al. “Polycystic Ovary Syndrome.” The Lancet Diabetes & Endocrinology, vol. 10, no. 9, Sept. 2022, pp. 668–680, https://doi.org/10.1016/s2213-8587(22)00163-2.

[6] Houston, Emma Jane, and Nicole Meredith Templeman. “Reappraising the Relationship between Hyperinsulinemia and Insulin Resistance in PCOS.” Journal of Endocrinology, vol. 265, no. 2, 1 Feb. 2025, https://doi.org/10.1530/joe-24-0269.

[7] Livadas, Sarantis, et al. “Polycystic Ovary Syndrome and Type 2 Diabetes Mellitus: A State-of-The-Art Review.” World Journal of Diabetes, vol. 13, no. 1, 15 Jan. 2022, pp. 5–26, www.ncbi.nlm.nih.gov/pmc/articles/PMC8771268/, https://doi.org/10.4239/wjd.v13.i1.5.

[8] Christ, Jacob P., and Marcelle I. Cedars. “Current Guidelines for Diagnosing PCOS.” Diagnostics, vol. 13, no. 6, 2023, p. 1113, www.ncbi.nlm.nih.gov/pmc/articles/PMC10047373/#:~:text=It%20is%20recommended%20to%20use,with%20exclusion%20of%20other%20relevant, https://doi.org/10.3390/diagnostics13061113.

[9] Lemaitre, Madleen, et al. “Polycystic Ovary Syndrome and Adipose Tissue.” Annales D’Endocrinologie, vol. 84, no. 2, Jan. 2023, https://doi.org/10.1016/j.ando.2022.11.004.

[10] Deng, Hongxia, et al. “Systematic Low-Grade Chronic Inflammation and Intrinsic Mechanisms in Polycystic Ovary Syndrome.” Frontiers in Immunology, vol. 15, no. 1, 19 Dec. 2024, https://doi.org/10.3389/fimmu.2024.1470283.

[11] Feigelman, Elina. “Prevalence of Prediabetes among Patients Suffering from Polycystic Ovary Syndrome with Different Body Mass Index - ProQuest.” Proquest.com, 2023, www.proquest.com/openview/a64dd3bebf35d00306e294acabc15c9d/1?pq-origsite=gscholar&cbl=2026366&diss=y. Accessed 4 Aug. 2025.

[12] Herbert, Shannon, and Kathleen Woolf. “Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS).” Nutrients, vol. 15, no. 24, 11 Dec. 2023, pp. 5069–5069, https://doi.org/10.3390/nu15245069.

[13] Bustami, Mona, et al. “The Prevalence of Overweight and Obesity among Women in Jordan: A Risk Factor for Developing Chronic Diseases.” Journal of Multidisciplinary Healthcare, vol. Volume 14, no. 2021, June 2021, pp. 1533–1541, https://doi.org/10.2147/jmdh.s313172.

[14] Muhaidat, Nadia, et al. “Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan.” International Journal of Environmental Research and Public Health, vol. 20, no. 5, 1 Jan. 2023, p. 4018, www.mdpi.com/1660-4601/20/5/4018, https://doi.org/10.3390/ijerph20054018.

[15] Burns, Kharis. “Polycystic Ovary Syndrome: Dissecting the Genetics, Phenotype and Health Outcomes of a Heterogeneous Condition.” The UWA Profiles and Research Repository, 2024, research-repository.uwa.edu.au/en/publications/polycystic-ovary-syndrome-dissecting-the-genetics-phenotype-and-h, https://doi.org/10.26182/9k7t-n071. Accessed 4 Aug. 2025.

[16] Amiri, Mina, et al. “The Association between Obesity and Polycystic Ovary Syndrome: An Epidemiologic Study of Observational Data.” The Journal of Clinical Endocrinology & Metabolism, vol. 109, no. 10, 30 July 2024, pp. 2640–2657, academic.oup.com/jcem/article-abstract/109/10/2640/7724236?redirectedFrom=fulltext, https://doi.org/10.1210/clinem/dgae488. Accessed 6 Apr. 2025.

[17] Gulam Saidunnisa Begum, et al. “Prevalence of Polycystic Ovary Syndrome (PCOS) and Its Associated Risk Factors among Medical Students in Two Countries.” International Journal of Environmental Research and Public Health, vol. 21, no. 9, 2 Sept. 2024, pp. 1165–1165, https://doi.org/10.3390/ijerph21091165.

[18] Mumusoglu, Sezcan, and Bulent Okan Yildiz. “Polycystic Ovary Syndrome Phenotypes and Prevalence: Differential Impact of Diagnostic Criteria and Clinical versus Unselected Population.” Current Opinion in Endocrine and Metabolic Research, vol. 12, June 2020, pp. 66–71, https://doi.org/10.1016/j.coemr.2020.03.004.

[19] Zeng, Xin, et al. “Polycystic Ovarian Syndrome: Correlation between Hyperandrogenism, Insulin Resistance and Obesity.” Clinica Chimica Acta, vol. 502, no. 3, Mar. 2020, pp. 214–221, https://doi.org/10.1016/j.cca.2019.11.003.

[20] Mosorin, Maria-Elina. “Metabolic Effects of Hormonal Contraception in Women with and without Polycystic Ovary Syndrome.” B78ea1cb-5171-496a-8ef1-B04feae46fa7, 19 Jan. 2024, oulurepo.oulu.fi/handle/10024/47269.

[21] Yan, Kaiyi. “Recent Advances in the Effect of Adipose Tissue Inflammation on Insulin Resistance.” Cellular Signalling, vol. 120, no. 11, 17 May 2024, p. 111229, www.sciencedirect.com/science/article/abs/pii/S0898656824001979, https://doi.org/10.1016/j.cellsig.2024.111229.

[22] Mohammed Saeed Almarri, Khaloud. “Psychological Distress and Physical Activity among Women with a Diagnosis of Polycystic Ovary Syndrome in Qatar: A Cross-Sectional Study.” Proquest.com, 1 May 2024, www.proquest.com/openview/e97d9b0544d2da0d61f5e867785dc525/1?pq-origsite=gscholar&cbl=2026366&diss=y.

[23] Abdullah Addas. “Impact of Neighborhood Safety on Adolescent Physical Activity in Saudi Arabia: Gender and Socio-Economic Perspectives.” Frontiers in Public Health, vol. 13, no. 1, 23 Jan. 2025, https://doi.org/10.3389/fpubh.2025.1520851.

[24] Awwad, Oriana, et al. “Use of Complementary and Alternative Medicine among Females with Polycystic Ovary Syndrome in Jordan: A Cross-Sectional Study.” BMJ Open, vol. 14, no. 12, 1 Dec. 2024, pp. e088945–e088945, https://doi.org/10.1136/bmjopen-2024-088945. Accessed 28 Apr. 2025.

[25] Tamimi, Ahmad, et al. “The Transformation of Jordan’s Healthcare System in an Area of Conflict.” BMC Health Services Research, vol. 24, no. 1, 6 Sept. 2024, bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-11467-1, https://doi.org/10.1186/s12913-024-11467-1.

[26] Choi, Yujin, et al. “Association of Dietary Behaviors with Poor Sleep Quality and Increased Risk of Obstructive Sleep Apnea in Korean Military Service Members.” Nature and Science of Sleep, vol. 14, no. 2022, 25 Sept. 2022, pp. 1737–1751, www.dovepress.com/association-of-dietary-behaviors-with-poor-sleep-quality-and-increased-peer-reviewed-fulltext-article-, https://doi.org/10.2147/NSS.S378564. Accessed 13 Nov. 2022.

[27] Bhandari, Mohit, et al. “Effects of Bariatric Surgery on People with Obesity and Polycystic Ovary Syndrome: A Large Single Center Study from India.” Obesity Surgery, vol. 32, no. 10, 26 July 2022, pp. 3305–3312, https://doi.org/10.1007/s11695-022-06209-3.

[28] Carter, Faith. “Longitudinal Assessments of Ovarian Morphology in Women with PCOS: Implications for Diagnosis and Hypocaloric Interventions.” Proquest.com, 10 Aug. 2024, www.proquest.com/openview/e064bb293453c67bb367713f5760576f/1?pq-origsite=gscholar&cbl=18750&diss=y. Accessed 4 Aug. 2025.

[29] Peng, Ge, et al. “The Effects of First-Line Pharmacological Treatments for Reproductive Outcomes in Infertile Women with PCOS: A Systematic Review and Network Meta-Analysis.” Reproductive Biology and Endocrinology, vol. 21, no. 1, 3 Mar. 2023, https://doi.org/10.1186/s12958-023-01075-9.

[30] Robson, Emma K., et al. “Effectiveness of Weight-Loss Interventions for Reducing Pain and Disability in People with Common Musculoskeletal Disorders: A Systematic Review with Meta-Analysis.” The Journal of Orthopaedic and Sports Physical Therapy, vol. 50, no. 6, 1 June 2020, pp. 319–333, pubmed.ncbi.nlm.nih.gov/32272032/, https://doi.org/10.2519/jospt.2020.9041.

[31] Michele, Stefano Di, et al. “Ultrasound Assessment in Polycystic Ovary Syndrome Diagnosis: From Origins to Future Perspectives—a Comprehensive Review.” Biomedicines, vol. 13, no. 2, 12 Feb. 2025, pp. 453–453, www.mdpi.com/2227-9059/13/2/453, https://doi.org/10.3390/biomedicines13020453.

[32] Wang, Youfa, et al. “Has the Prevalence of Overweight, Obesity and Central Obesity Levelled off in the United States? Trends, Patterns, Disparities, and Future Projections for the Obesity Epidemic.” International Journal of Epidemiology, vol. 49, no. 3, 4 Feb. 2020, pp. 810–823, www.ncbi.nlm.nih.gov/pubmed/32016289, https://doi.org/10.1093/ije/dyz273.

[33] Abiero, Beatrice, et al. “Military Health System Access to Care: Performance and Perceptions.” Military Medicine, vol. 185, no. 7-8, 7 Jan. 2020, pp. e1193–e1199, https://doi.org/10.1093/milmed/usz463. Accessed 19 Jan. 2022.

[34] Barber, Thomas M., and Stephen Franks. “Obesity and Polycystic Ovary Syndrome.” Clinical Endocrinology, vol. 95, no. 4, 31 Jan. 2021, https://doi.org/10.1111/cen.14421.

[35] Ding, Haigang, et al. “Resistance to the Insulin and Elevated Level of Androgen: A Major Cause of Polycystic Ovary Syndrome.” Frontiers in Endocrinology, vol. 12, no. 2021, 20 Oct. 2021, https://doi.org/10.3389/fendo.2021.741764.

[36] Mora, Ignasi, et al. “Emerging Models for Studying Adipose Tissue Metabolism.” Biochemical Pharmacology, vol. 223, no. 24, 12 Mar. 2024, p. 116123, www.sciencedirect.com/science/article/abs/pii/S0006295224001060, https://doi.org/10.1016/j.bcp.2024.116123.

[37] Dietary Patterns to Prevent and Manage Diet-Related Disease across the Lifespan. National Academies Press EBooks, National Academies Press (US), 20 Dec. 2023, www.ncbi.nlm.nih.gov/books/NBK598421/. Accessed 4 Sept. 2024.

[38] Diaz-Thomas, Alicia, et al. “Endocrine Health and Health Care Disparities in the Pediatric and Sexual and Gender Minority Populations: An Endocrine Society Scientific Statement.” The Journal of Clinical Endocrinology and Metabolism, vol. 108, no. 7, 16 May 2023, pp. 1533–1584, https://doi.org/10.1210/clinem/dgad124.

[39] Cardiometabolic Comorbidities and Complications of Obesity and Chronic Kidney Disease (CKD). Journal of Clinical & Translational Endocrinology, vol. 36, no. 24, 1 June 2024, pp. 100341–100341, https://doi.org/10.1016/j.jcte.2024.100341.

[40] Jayasena, Channa N, et al. “Society for Endocrinology Guideline for Understanding, Diagnosing and Treating Female Hypogonadism.” Clinical Endocrinology, vol. 101, no. 5, 21 June 2024, https://doi.org/10.1111/cen.15097.