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Metabolic factors influencing menstrual function during weight loss: Leptin levels: This adipocyte-derived hormone decreases with fat loss and plays a crucial role in reproductive function signaling Insulin sensitivity: Improved insulin sensitivity can normalize androgen levels, particularly beneficial in PCOS Inflammatory markers: Reduction in chronic low-grade inflammation associated with obesity Sex hormone-binding globulin (SHBG): Levels typically increase with weight loss, affecting free hormone availability For women with obesity-related reproductive dysfunction, particularly those with PCOS, moderate and sustained weight loss often improves menstrual regularity over time

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Injectable Vitamin B12 may be given subcutaneously or intramuscularly