Energy availability and infertility

Abstract

Purpose of review: To relate recent research on the dependence of reproductive function on energy availability in women to recent clinical experience in the treatment of anorexia nervosa.

Recent findings: The dependence of luteinizing hormone pulsatility on energy availability declines during adolescence, but the responses of leptin and other peripheral signals of energy deficiency do not. This finding suggests that central sensitivity to these signals may decline during adolescence. Energy availability may be inadequate in anorexia nervosa patients whose menstrual cycles are not restored after weight recovery.

Summary: Energy availability is a theoretically satisfying and operationally controllable concept for understanding, investigating, and managing the energy dependence of reproductive function. Nutritional intervention to restore menstrual cycles in anorexia nervosa patients might be more successful if it was guided by energy availability and ovarian volume rather than energy intake and body weight.