Amenorrhea: Not a Good Gauge of Prognosis

An unstable symptom that can’t be
relied upon as a gauge of illness

Amenorrhea can’t be used to predict the severity of an eating disorder and has little prognostic value in patients with eating disorders, according to a group of researchers at the University of Turin’s Eating Disorders Center, Turin, Italy.

Dr. Giovanni Abbate-Daga and colleagues studied 184 outpatients with eating disorders to gain longitudinal data about amenorrhea (Eat Weight Disord. 2012; 17: e78. Epub Sep 26). A group of 184 outpatients were recruited: 50 with AN restrictive type, 75 amenorrheic eating disorder not otherwise specified (EDNOS) patients, 24 patients recovered from AN but with persistent amenorrhea, and 35 amenorrheic patients without histories of eating disorders. All participants were clinically assessed by psychiatrists and gynecologists at the beginning of treatment and at one-year follow-up. The participants also completed several psychometric tests, including the Eating Disorder Inventory-2, Temperament and Character Inventory, and the Beck Depression Inventory.

After treatment for their eating disorder was completed, a large portion of the women resumed menses, but very few recovered completely from their eating disorder. Results from the psychometric tests did not provide any predictions about recovery of menses in the different groups; however, body mass index and some biological variables were associated with restoration of menses in patients with eating disorders.

Dr. Abbate-Daga and colleagues reported that the resumption of menses was neither associated with less severe eating disorder symptoms at the beginning of treatment nor with unequivocal psychopathological changes after treatment. The authors stress that clinicians consider not only the presence or absence of regular menses but also that they improve screening for underlying eating disorders and assessment of amenorrheic patients.