HYPOTHALAMIC AMENORRHEA AND HIDDEN NUTRITIONAL INSULTS

OBJECTIVE: We examined whether abnormal nutrition is an associated event in idiopathic hypothalamic amenorrhea. METHODS: Eighteen amenorrheic subjects were compared to 36 normal controls using endocrine, nutritional, and psychological evaluations. RESULTS: Controls were closer to their ideal weight (97.2 versus 89.7%; P <.05) than amenorrheics despite similar ages and heights. Amenorrheics denied eating disorders; however, our evaluation showed more eating disorders (55 versus 26%; P <.05), higher scores on a scale of earing behavior (22.28 versus 10.36; P <.001), twice as much fiber intake (26.14 versus 14.69 g/day) and less fat intake (20.7 versus 27.10 g/day) (P <.001), more aerobic activity (85 versus 58%) despite expending fewer calories per day (2303.7 versus 2576.7 kcal/day; P <.05), and similar caloric intake. CONCLUSIONS: Significant abnormalities suggest that a greater percentage of hypothalamic amenorrhea occurs on a nutritional basis than previously suspected and should be searched for in depth.