Title:Menstrual Disorders Related to Eating Disorders
Volume: 22
Issue: 5
Author(s): Walter Milano, Paola Ambrosio, Francesca Carizzone, Valeria De Biasio, Maria Gabriella Foia, Biancamaria Saetta, Maria Francesca Milano and Anna Capasso*
Affiliation:
- Department of Pharmacy, University of Salerno, Fisciano, 84084
Salerno, Italy
Keywords:
Amenorrhea, Atrophic Vaginitis, Eating Disorders, Menstrual Cycle, Pelvic Pain, Psychiatric Pathologies.
Abstract: Eating Disorders (ED) are associated with multiple physical complications that strongly affect the
physical health of these young and fragile patients and can also cause significant mortality, the highest among
psychiatric pathologies. Among the various organic complications, albeit still little known, the gynecological
implications, up to infertility, are very widespread. Both among adolescent and adult patients, gynecological
symptoms can be very widespread and range from menstrual irregularities to amenorrhea, from vaginitis to
ovarian polycystosis, up to complications during the gestational phase and in postpartum, in addition to the possible
consequences on the unborn child. Among the most frequent and significant gynecological disorders in
women with ED, there are menstrual irregularities that may occur with oligomenorrhea or even amenorrhea.
This symptom, although no longer part of the DSM-5 diagnostic criteria for defining Anorexia Nervosa (AN),
must be considered a very relevant event in the overall evaluation of young women and adolescents with eating
disorders. Functional Hypothalamic Amenorrhea in ED patients is related to psychological distress, excessive
exercise, disordered eating, or a combination of these factors which results in suppression of the hypothalamic-
pituitary-ovarian axis, resulting in hypoestrogenism. The objective of this paper is to summarize the causes
and the mechanism underlying the menstrual disorders and to provide a better understanding of the correlation
between the reproductive system and the mechanisms that regulate food intake and eating habits. In addition,
early recognition of risk factors for eating disorders for gynecological implications can help put more accurate
assessments of patients to prevent potentially fatal complications. The importance of the involvement of specialist
gynecologists in the multidisciplinary team that has to follow patients with eating disorders is also discussed.