title: Pulsatile gonadotropin-releasing hormone therapy in persistent amenorrheic weight-recovered anorexia nervosa patients.
abstract: To compare hormonal and clinical responses to GnRH pulsatile treatment in weight-recovered anorexia nervosa patients (Rec-AN) with persistent functional hypothalamic amenorrhea (HA) vs. in patients with secondary and primary HA.
  
  
  
  Retrospective, observational, ambulatory study.
  
  
  
  University hospital.
  
  
  
  Forty-one women: 19 Rec-AN (body mass index >18.5 kg/m2without menses recovery), 15 secondary HA without any eating disorders patients (SHA), and 7 primary HA patients (PHA).
  
  
  
  Gonadotropin-releasing hormone pulsatile therapy.
  
  
  
  Baseline E2, LH, and P plasma levels and their changes during induction cycles; ovulation, follicular recruitment, and pregnancies.
  
  
  
  The Rec-AN group displayed higher basal E2and LH plasma levels after GnRH injection compared with SHA and PHA. Higher E2and LH levels were observed during induction cycles in Rec-AN compared with SHA and PHA. Follicular recruitment was higher in Rec-AN. The ovulation rate was higher in Rec-AN compared with PHA but similar to SHA.
  
  
  
  This study showed increased gonadal status and higher E2response to pulsatile GnRH therapy in persistent amenorrheic weight-recovered AN compared with HA from other causes. It suggests that their individual set-point of body weight allowing a fully functional gonadal axis is not reached yet. Specific factors of gonadal inertia in Rec-AN still remain unclear.
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France; Eating Disorders, Addictions & Extreme Bodyweight Research Group EA 7423, Jean Monnet University, Saint-Etienne, France. Electronic address: natacha.germain@chu-st-etienne.fr.
authors.forename: Natacha
authors.initials: N
authors.lastname: Germain
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Fauconnier
authors.affiliation: Department of Histology and Embryology, University Hospital of Saint-Etienne, Saint-Etienne, France; Unité de Mixte de Recherche Institut National de la Santé et de la Recherche Médicale 1059, Jean Monnet University, Saint Etienne, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Klein
authors.affiliation: Eating Disorders, Addictions & Extreme Bodyweight Research Group EA 7423, Jean Monnet University, Saint-Etienne, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Wargny
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: Yadh
authors.initials: Y
authors.lastname: Khalfallah
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Papastathi-Boureau
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France; Eating Disorders, Addictions & Extreme Bodyweight Research Group EA 7423, Jean Monnet University, Saint-Etienne, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Estour
authors.affiliation: Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University hospital of Saint-Etienne, Saint-Etienne, France; Eating Disorders, Addictions & Extreme Bodyweight Research Group EA 7423, Jean Monnet University, Saint-Etienne, France.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Galusca
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000009:adverse effects; D006785:Hospitals, University; D006801:Humans; D055104:Infusions, Subcutaneous; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000187:drug effects*; D010060:Ovulation / Q000187:drug effects; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood; D020551:Pulse Therapy, Drug; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D015415:Biomarkers; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone
keywords: Anorexia nervosa; hypothalamic amenorrhea; pulsatile GnRH therapy