"I only focused on my uterus and ovary health, but…" The 'abnormal signals' your body sends before pregnancy

Women preparing for pregnancy should pay attention not only to the health of their uterus and ovaries but also to weight, menstrual cycles, and hormonal changes. Obesity can increase the risk of complications such as gestational diabetes and gestational hypertension, making management necessary before pregnancy. In addition, uterine fibroids or endometriosis can affect pregnancy and childbirth, and menstrual abnormalities may be a sign of ovulation disorders or hormonal imbalance.

Obesity can also affect women's ovulation and the pregnancy process. Increased body fat can lead to insulin resistance and hormonal imbalances, and in women with polycystic ovary syndrome, ovulation disorders and infertility may worsen. Obesity during pregnancy can increase the risk of gestational diabetes, gestational hypertension, preeclampsia, cesarean section, and macrosomia. Managing weight, blood sugar, and blood pressure before pregnancy can help reduce the risk of complications during pregnancy.

However, during pregnancy, rather than rapidly losing weight, one should check and manage the appropriate range of weight gain based on pre-pregnancy weight and gestational weeks. Excessive dietary restrictions or over-exercising may be detrimental to the health of both the pregnant woman and the fetus. Women preparing for pregnancy should maintain a healthy weight through a balanced diet and regular exercise, and if they have underlying conditions such as diabetes or hypertension, it is advisable to develop a management plan with medical professionals before pregnancy.

Uterine fibroids are benign tumors that arise from the muscle layer of the uterus and are commonly seen in women of childbearing age. Having fibroids does not necessarily make pregnancy difficult, but depending on the size, location, and number of fibroids, they can affect pregnancy and its maintenance. In particular, submucosal fibroids, which protrude inward into the uterine cavity, can affect the implantation environment of the fertilized egg and may be associated with infertility or recurrent miscarriages. Fibroids occurring in the uterine muscle layer can also affect pregnancy if they are large in size or deform the uterine cavity.

In some pregnant women, fibroids may increase the risk of preterm birth, placental-related issues, abnormal fetal position, or cesarean section. However, not all pregnant women with fibroids experience these complications. If planning a pregnancy, it is best to check the size and location of fibroids through an ultrasound examination and consult with an obstetrician-gynecologist regarding the possibility of pregnancy and the need for treatment.

Endometriosis is a condition in which tissue similar to the endometrium grows outside the uterus, causing inflammation and adhesions. It can cause severe menstrual pain, pelvic pain, and dyspareunia (painful intercourse). If an ovarian endometrioma develops or adhesions form between the fallopian tubes and surrounding tissues, it may lead to difficulties in pregnancy. In particular, if there is an ovarian endometrioma or a history of surgery, the possibility of decreased ovarian reserve should also be considered.

Some studies report that women with endometriosis may have a higher risk of certain pregnancy complications, such as early miscarriage, ectopic pregnancy, gestational hypertension, and preterm birth. However, these risks do not manifest in all patients, and having endometriosis does not mean one should avoid pregnancy. It is important for women preparing for pregnancy to undergo a comprehensive evaluation of the severity of endometriosis, ovarian function, age, and pregnancy plans.

If menstrual cycles are excessively irregular, if menstrual flow suddenly increases, or if menstruation stops for a long period, one should investigate the cause rather than assuming it is a simple change in menstruation. Menstrual abnormalities can occur due to various causes such as stress, rapid weight changes, excessive exercise, polycystic ovary syndrome, thyroid disorders, and hyperprolactinemia. In particular, if ovulation is irregular or does not occur, pregnancy may become difficult.

Conditions that cause ovulation disorders, such as polycystic ovary syndrome, may also appear alongside insulin resistance or obesity. If ovulation disorders persist, difficulties may arise when planning a pregnancy, and after conception, the risk of metabolic-related complications such as gestational diabetes should be considered. Since treatment methods for menstrual abnormalities vary depending on the cause, it is best to record changes in menstrual cycles and bleeding volume and seek obstetric-gynecological care if abnormalities persist.

External contributor - Professor Park Jung-hyun, Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, Catholic University of Korea