title: Recovery of menstrual cycle after therapy for anorexia nervosa.
abstract: OBJECTIVE
  Although the relation between sexual dysfunction, undernourishment and weight loss is clear, amenorrhea sometimes precedes weight loss and may persist despite later weight gain. We therefore studied the variations in anthropometric variables in women with restrictive anorexia nervosa (AN) at the time they recovered their menstrual cycle.
  
  
  METHODS
  We undertook a longitudinal study of 40 women with AN. All were in secondary amenorrhea at the start of the outpatient treatment program. Leptin concentrations were measured during the early follicular phase after the patients had recovered their menstrual cycle and had had two regular cycles. Body composition was measured by multifrequency bioelectric impedentiometry and the lean mass, fat mass and percentage fat were recorded.
  
  
  RESULTS
  The menstrual cycle returned in 25% of the patients with a BMI of 17 or lower, in 50% of the patients with fat percentages of 20% or lower and in 25% with fat percentages of 17% or lower. Over 20% of the patients recovered their menstrual cycle without having leptin figures above 1.85 ng/ml.
  
  
  CONCLUSIONS
  Prediction of recovery of menstruation in women with AN is difficult, as anthropometric variables alone are not sufficient; other factors have also to be taken into account.
authors: Unidad de Trastornos del Comportamiento Alimentario, Servicio de Endocrinología, Hospital Regional Carlos Haya, Malaga, Spain. fjtinahones@terra.es
authors: F J
authors: FJ
authors: Tinahones
authors: B
authors: B
authors: Martínez-Alfaro
authors: M
authors: M
authors: Gonzalo-Marín
authors: J M
authors: JM
authors: García-Almeida
authors: L
authors: L
authors: Garrido-Sánchez
authors: F
authors: F
authors: Cardona