Slupik R I
Northwestern University Medical School, Children's Memorial Hospital and Northwestern Memorial Hospital, Chicago, Illinois, USA.
Int J Fertil Womens Med. 1999 May-Jun;44(3):125-30.
Anorexia nervosa is a complex psychiatric disorder with endocrinologic manifestations primarily affecting adolescent females. The classic triad of presenting symptoms is weight loss in excess of 15% of ideal body weight, behavioral changes and amenorrhea (secondary or primary). The menstrual irregularities may cause the patient or family to seek gynecologic consultation before the diagnosis of primary psychiatric disorder has been made. Bulimia is a separate disease entity characterized by compulsive overeating binges followed by compensatory purging behavior to maintain a desired weight. Depending on the degree of psychiatric disturbance, purging, and ultimate body weight, such patients may or may not present with menstrual abnormalities. Hypoestrogenic hypothalamic amenorrhea in both types of patients may result in osteoporosis, stress fractures, and infertility. Obese women, in contrast to the above, most often have abnormally heavy bleeding patterns secondary to chronic anovulation. Their-short term gynecologic concerns may be cycle control or infertility, but over the long term they are at increased risk for endometrial hyperplasia and cancer.
神经性厌食症是一种复杂的精神疾病，伴有内分泌表现，主要影响青春期女性。典型的三联征症状是体重减轻超过理想体重的15%、行为改变和闭经（继发性或原发性）。月经不调可能导致患者或其家人在原发性精神疾病诊断之前就寻求妇科咨询。暴食症是一种独立的疾病实体，其特征是强迫性暴饮暴食，随后通过代偿性清除行为来维持期望的体重。根据精神障碍的程度、清除行为和最终体重，这类患者可能出现或不出现月经异常。这两种类型患者的低雌激素性下丘脑闭经都可能导致骨质疏松、应力性骨折和不孕。与上述情况相反，肥胖女性最常见的是由于慢性无排卵导致异常大量出血。她们短期的妇科问题可能是月经周期控制或不孕，但从长期来看，她们患子宫内膜增生和癌症的风险增加。
