Amenorrhea and predictors for remenorrhea in anorexia nervosa: a psychoendocrinological study in inpatients

Abstract

34 consecutively admitted anorexia nervosa inpatients were studied for variables relevant for 'early' vs. 'late' amenorrhea and for probable remenorrhea after therapy. The subsample reporting 'early' amenorrhea, i.e. preceding weight loss (n = 11), was characterized by less 'anorexia-specific' psychological traits and more weight loss before admission and a more marked (= pathological) FSH responsiveness to GnRH stimulation. Hence--contrary to our expectation--'early' amenorrhea seems to be a 'nonpsychogenic' phenomenon. Analysis according to FSH hyperresponsiveness yielded no additional information. Studying LH changes during therapy we found that a nonrise in basal LH secretion is associated with a type of anorexia characterized by early onset and a less severe but protracted course before admission, which then proves also more recalcitrant to therapy. The subsample which attained LH fluctuation before discharge showed a clear reduction of 'weight phobia' and a higher weight both on admission and before discharge.