UOSD Eating Disorder Unit, Mental Health Department, ASL Napoli 2 Nord, 80027 Napoli, Italy.
Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy.
Endocr Metab Immune Disord Drug Targets. 2022;22(5):471-480. doi: 10.2174/1871530321666210625145345.
Eating Disorders (ED) are associated with multiple physical complications that strongly affect the physical health of these young and fragile patients and can also cause significant mortality, the highest among psychiatric pathologies. Among the various organic complications, albeit still little known, the gynecological implications, up to infertility, are very widespread. Both among adolescent and adult patients, gynecological symptoms can be very widespread and range from menstrual irregularities to amenorrhea, from vaginitis to ovarian polycystosis, up to complications during the gestational phase and in postpartum, in addition to the possible consequences on the unborn child. Among the most frequent and significant gynecological disorders in women with ED, there are menstrual irregularities that may occur with oligomenorrhea or even amenorrhea. This symptom, although no longer part of the DSM-5 diagnostic criteria for defining Anorexia Nervosa (AN), must be considered a very relevant event in the overall evaluation of young women and adolescents with eating disorders. Functional Hypothalamic Amenorrhea in ED patients is related to psychological distress, excessive exercise, disordered eating, or a combination of these factors which results in suppression of the hypothalamic- pituitary-ovarian axis, resulting in hypoestrogenism. The objective of this paper is to summarize the causes and the mechanism underlying the menstrual disorders and to provide a better understanding of the correlation between the reproductive system and the mechanisms that regulate food intake and eating habits. In addition, early recognition of risk factors for eating disorders for gynecological implications can help put more accurate assessments of patients to prevent potentially fatal complications. The importance of the involvement of specialist gynecologists in the multidisciplinary team that has to follow patients with eating disorders is also discussed.
进食障碍（ED）与多种身体并发症相关，这些并发症严重影响这些年轻脆弱患者的身体健康，并可能导致显著的死亡率，在精神病理学中死亡率最高。在各种器官并发症中，尽管仍然知之甚少，但妇科并发症，甚至到不孕，非常普遍。无论是在青少年还是成年患者中，妇科症状都可能非常广泛，从月经不规律到闭经，从阴道炎到卵巢多囊症，甚至在妊娠阶段和产后都会出现并发症，此外还可能对胎儿造成潜在影响。在 ED 患者中，最常见和最重要的妇科疾病之一是月经不规律，可能表现为月经稀少甚至闭经。尽管这种症状不再是 DSM-5 定义神经性厌食症（AN）的诊断标准之一，但在对患有进食障碍的年轻女性和青少年进行全面评估时，必须将其视为一个非常相关的事件。ED 患者的功能性下丘脑性闭经与心理困扰、过度运动、饮食失调或这些因素的组合有关，这些因素导致下丘脑-垂体-卵巢轴抑制，导致雌激素水平降低。本文的目的是总结月经失调的原因和机制，并更好地理解生殖系统与调节食物摄入和饮食习惯的机制之间的相关性。此外，早期识别与妇科并发症相关的进食障碍风险因素有助于对患者进行更准确的评估，以预防潜在的致命并发症。还讨论了妇科专家参与多学科团队对患有进食障碍的患者进行随访的重要性。
