Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York 11042, USA; Donald and Barbara Zucker, School of Medicine at Hofstra / Northwell, Hempstead, New York, USA.
Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York 11042, USA; Donald and Barbara Zucker, School of Medicine at Hofstra / Northwell, Hempstead, New York, USA.
Curr Probl Pediatr Adolesc Health Care. 2022 Aug;52(8):101240. doi: 10.1016/j.cppeds.2022.101240. Epub 2022 Jul 28.
Although amenorrhea is no longer a specific criterion required to make the diagnosis of anorexia nervosa (AN), the relationship between restrictive eating and menstrual status remains important in the diagnosis, treatment, and consequences for patients with eating disorders. Clinicians should understand the relationship between menstrual irregularities and malnutrition due to eating disorders, as it may be possible to intervene sooner if the diagnosis is made earlier. Treatment of AN (in those who are underweight) and atypical AN (in those who are not underweight) is aimed at cessation of restrictive thoughts and behaviors, restoration of appropriate nutrition and weight, and normal functioning of the body. While eating disorder thoughts and behaviors are helped by both therapy and nutrition, regular functioning of the body, including regular menstruation, is linked to both appropriate nutrition and weight. Patients who are not underweight based on their body mass index (BMI) may still have oligo/amenorrhea due to their caloric restriction; thus any patient who has irregular menses should have a detailed dietary evaluation as part of their workup. Timely diagnosis and treatment of patients with eating disorders and amenorrhea is important due to the impact on bone mass accrual for adolescents who have prolonged amenorrhea. Menstrual abnormalities may also be seen in patients with bulimia nervosa (BN).
尽管闭经不再是诊断神经性厌食症 (AN) 的特定标准，但限制饮食与月经状况之间的关系在饮食障碍患者的诊断、治疗和后果中仍然很重要。临床医生应该了解与饮食紊乱相关的月经不规律和营养不良之间的关系，如果更早地做出诊断，可能更容易进行干预。AN（体重不足的人）和非典型 AN（体重正常的人）的治疗旨在停止限制性的思维和行为，恢复适当的营养和体重，以及身体的正常功能。虽然饮食障碍的思维和行为既可以通过治疗也可以通过营养来改善，但身体的正常功能，包括正常的月经，与适当的营养和体重都有关系。根据体重指数 (BMI) 体重不足的患者可能仍然由于热量限制而出现少经/闭经；因此，任何月经不规律的患者都应该进行详细的饮食评估作为其检查的一部分。由于青春期患者长期闭经会影响骨量积累，因此及时诊断和治疗饮食障碍和闭经患者非常重要。月经异常也可能见于神经性贪食症 (BN) 患者。
