High Insulin Levels may Triple Risk of Abnormal Uterine Bleeding in Premenopausal Women: Study

A study published in Menopause has found that elevated insulin levels are associated with a threefold increase in the risk of abnormal uterine bleeding in premenopausal women, potentially due to chronic inflammation caused by hyperinsulinemia.

Insulin resistance is becoming more common because of a combination of lifestyle factors, genetics, and medical conditions. A lot of those same risk factors play a role in abnormal uterine bleeding. A new study sets out to prove the connection between the two as a means to better predict abnormal uterine bleeding.

Abnormal uterine bleeding has become more common, with approximately 30% of women of reproductive age experiencing it. More than $34 billion in healthcare costs alone is spent on the problem, not to mention the added economic burden of increased work absenteeism and an overall decreased quality of life. Currently, much of the research in this area focuses on the diagnosis and treatment of abnormal uterine bleeding rather than prevention, including a focus on reducing cardiovascular disease risk factors as treatment.

At the same time, the incidence of insulin resistance, in which the body’s cells don’t respond normally to insulin, and its related condition, hyperinsulinemia (a state of having higher than normal insulin levels in the blood), are on the rise because of a lot of the same risk factors such as excess weight (especially belly fat), sedentary lifestyles, and poor diets.

Researchers in a new study involving a little more than 200 premenopausal women aged 18 to 54 years hypothesized that elevated fasting insulin is associated with both structural and hormonal causes of abnormal uterine bleeding. The study was designed to be the basis for future larger studies examining potential relationships between cardiovascular disease risk factors and the development of benign gynecologic disease, but it provides preliminary evidence of the significant association between hyperinsulinemia and abnormal uterine bleeding.

In the current study, participants underwent fasting insulin assessment with additional markers of metabolic syndrome, including body mass index (BMI), high-density lipoprotein, and waist-to-hip ratio. Logistic regression was used to examine the association between hyperinsulinemia and abnormal uterine bleeding, adjusting for confounders such as age, race, and low-density lipoprotein, and found an association between hyperinsulinemia and abnormal uterine bleeding, with BMI playing a unique role in this relationship.

Survey results are published in the article “The uterus is an end organ: a preliminary study of the association between abnormal uterine bleeding and hyperinsulinemia.”

“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,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

Reference:

The uterus is an end organ: a preliminary study of the association between abnormal uterine bleeding and hyperinsulinemia, Menopause (2025). DOI: 10.1097/GME.0000000000000002548. menopause.