Secondary Amenorrhea After Weight Recovery

Secondary amenorrhea is common in adolescents with eating disorders, and one-third of patients with anorexia nervosa remain amenorrheic even after weight recovery. This hypothalamic dysfunction suggests a chronic energy deficit, according to Dr. Wendy Sterling and colleagues at Schneider Children’s Hospital, New Hyde Park, NY. They used indirect calorimetry to study energy expenditure in two groups of normal-weight adolescents with eating disorders. Both groups of women, from 12 to 22 years of age, had regained weight after treatment, and were within 90% to 122% of their ideal body weight. All were slightly below average weight. Seventy of the women had regular menses (defined as 3 normal periods after weight recovery) and 43 were amenorrheic (absence of 3 or more cycles after weight recovery). As Dr. Sterling reported at the recent ICED in Baltimore, the amenorrheic women had significantly lower resting energy expenditure levels than did the women with normal menses (P= < 0.001). There were no significant differences by age, but the amenorrheic women were an average of 1.2 inches shorter than women in the other group. A hypometabolic state existed in those with secondary amenorrhea. When the women were categorized by type of eating disorder, the researchers found no significant differences between the two groups.