Adolescent obesity has become a significant global concern, affecting physical, emotional, and reproductive health. Among its many consequences, hormonal dysregulation stands as a key contributor to menstrual disorders in adolescent girls. This review explores how obesity disrupts the endocrine system, particularly impacting insulin, leptin, estrogen, and androgen levels, leading to conditions such as oligomenorrhea, amenorrhea, menorrhagia, and polycystic ovarian syndrome (PCOS). The review underscores the role of adipose tissue as an active endocrine organ and elaborates on the mechanisms linking metabolic imbalance to reproductive dysfunction. It also highlights the psychosocial implications of menstrual problems in adolescents and emphasizes the vital role of nurses in early detection, prevention, and education. By providing an integrative approach, this article aims to support healthcare professionals in understanding the multifaceted connection between obesity and menstrual irregularities. Effective lifestyle interventions and timely nursing support can help mitigate long-term reproductive issues and promote holistic adolescent health.