[Gynecologic and endocrinologic sequelae of bulimia--hormonal changes].
BACKGROUND
Gynecological problems are one of the most frequent somatic complications of eating disorders.


OBJECTIVE
The purpose of the present study was to assess the role of improper eating habits causing menstrual disturbances, anovulation and related hormonal changes. Latent bulimia nervosa is in the focus of attention since amenorrhea is considered as a diagnostic criterion of anorexia nervosa.


METHODS
Subjects of the BITE (Bulimia Investigation Test, Edinburgh) test were infertile patients (n = 34) of the gynecological outpatient departments after medical examination, blood-test (LH, FSH, androstenedione, DHEAS, progesterone, testosterone, SHBG, prolactin) and ultrasonic examination (uterus and ovaries).


RESULTS
Symptoms and severity subscales of the BITE test and body mass index (BMI) were close correlation (p = 0.003, p = 0.033). In comparison with previous results, EDNOS (Eating Disorders Not Otherwise Specified) prevalence was 48%. Of hormonal changes, low LH and FSH levels (6/6) and hyperandrogenism (5/6) were significant in patients with subclinical eating disorders (n = 6) by infertile women as compared with the "normal" infertile group (n = 18; 7/18, 8/18).


CONCLUSIONS
The recent results suggests that unsatisfactory nutrition (bulimic binges, "crash diet") is as relevant in hormonal dysfunction, menstrual disturbances and infertility as pathologically low weight in anorexia nervosa. Excessive application of contraceptives in therapy has to be taken into consideration.
Resch
Mária
M
Sopron Megyei Jogú Város, Erzsébet Kórház, Pszichiátriai Osztály, Budapest.
Szendei
György
G
Haász
Péter
P
D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D000735:Androstenedione / Q000097:blood; D000858:Anovulation / Q000209:etiology; D015992:Body Mass Index; D001835:Body Weight; D002032:Bulimia / Q000097:blood* / Q000150:complications*; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005831:Genital Diseases, Female / Q000097:blood* / Q000209:etiology*; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007247:Infertility, Female / Q000209:etiology; D007986:Luteinizing Hormone / Q000097:blood; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood
D006728:Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D006854:Hydrocortisone