This can also cause infertility and problems conceiving in women while the disease is active. Ovulation also fails to occur as a certain amount of estrogen is required for the LH surge that results in the release of the oocyte (egg).Īmenorrhea, primary and secondary, is a common characteristic of women and girls with anorexia, even early into their disorder. In female patients with anorexia nervosa, not only does reduced GnRH cause decreased production of estrogen from the ovaries but there is less peripheral production of estrogen from the normally present androgens (male sex hormones)-enzymes that convert androgens to estrogen are present in fat cells, which are severely depleted due to the extreme weight loss. 1,2,4,5 Generally, one must achieve a minimum of 90% ideal body weight in order normalize this axis. With anorexia nervosa and a disrupted axis, low levels of estrogen and testosterone are produced due to reduced pulses of GnRH from the hypothalamus. Normally, the hypothalamus secretes gonatropin-releasing hormone (GnRH) in a pulsatile manner, causing increased secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) from the pituitary gland, which causes production of various hormones from the ovaries (or testes) that ultimately result in increased levels of progesterone and estradiol (or, in males, testosterone). In both males and females, overexercise and/or caloric restriction causes a disruption in the hypothalamic-pituitary-gonadal axis, resulting in hypothalamic hypogonadism. Many of these hormonal changes are appropriate physiologic adaptations to help conserve energy but come at the detriment of bone health and other physiologic abnormalities. While most complications resolve with weight restoration, others can be enduring or permanent. Prolonged starvation greatly impacts the pituitary gland, thyroid gland, adrenal glands, gonads and bones. Endocrine Abnormalities of Anorexia NervosaĪnorexia nervosa and its associated malnutrition and overexercise, can cause a variety of endocrine abnormalities.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |