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Hum. Reprod. Advance Access published online on September 30, 2005
Human Reproduction, doi:10.1093/humrep/dei294
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received March 10, 2005
Revised July 19, 2005
Accepted July 25, 2005

Article

Predictors of functional and exercise amenorrhoea among eating and exercise disordered patients

Suzanne F. Abraham 1*, Bianca Pettigrew 2, Catherine Boyd 2, and Janice Russell 3

1 Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards
2 Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards; The Northside Clinic, Greenwich, University of Sydney, NSW 2065, Australia
3 Department of Psychological Medicine, Sydney; The Northside Clinic, Greenwich, University of Sydney, NSW 2065, Australia

* To whom correspondence should be addressed.
Suzanne F. Abraham, E-mail: sabraham{at}med.usyd.edu.au


  Abstract

BACKGROUND: The aim of this study was to investigate the predictors of amenorrhoea self-reported by patients who are suffering or recovering from eating or exercise disorders. METHODS: Menstrual status, eating and exercise behaviours and feelings, and weight history of 268 female patients, 16-40 years old and not taking oral contraception or hormone replacement, were assessed on admission to hospital or 12 months later. RESULTS: Most (134) had secondary amenorrhoea, 39 had oligomenorrhoea and 95 regular spontaneous menses. Amenorrhoea occurs in women with all types of eating disorder diagnoses including EDNOS (eating disorder not otherwise classified). The predictors of secondary amenorrhoea were: lower current BMI [odds ratio (OR) 0.59, confidence interval (CI) 0.50-0.68); a greater amount of body weight lost (OR 1.19, CI 1.06-1.33); exercising for mood, to burn up energy or for body image reasons (OR 1.50, CI 1.14-1.97); and younger age (OR 0.93, CI 0.87-1.00). Eating disorder patients with an exercise disorder were significantly more likely to report trying to reduce their food intake, to feel compelled to exercise and to have amenorrhoea/ oligomenorrhoea than eating disorder patients without an exercise disorder. CONCLUSION: The greater the self-report behaviours and feelings associated with energy debt, the more likely menstruation is to be disturbed. Energy balance needs to be assessed in all amenorrhoeic patients.

Keywords: amenorrhoea/eating disorders/energy balance/BMI/exercise disorder/EDNOS.
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