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Anorexia, Menstruation, and Bone Loss Recovery

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Updated December 09, 2007

Anorexia nervosa is a serious eating disorder that can have life-threatening consequences. About 90 to 95% of people who have anorexia nervosa are female. Girls and women who have anorexia nervosa starve themselves and exercise excessively to lose weight no matter how much they weigh. Frequently, amenorrhea or absence of menstruation is present in anorexia nervosa. Bone loss, or osteopenia, also usually occurs in anorexia nervosa which leads to a significantly higher risk of bone fractures.

According to a small study published in the Journal of Clinical Nutrition, the typical treatment for osteopenia in anorexia nervosa is estrogen. Estrogen therapy has not proven to be an effective treatment for increasing bone mineral density. After analyzing the results of the study, researchers now think the key to full recovery of bone loss in anorexia nervosa patients is both nutritional and hormonal.

Women, in the study, who gained weight to at least 90% of normal through nutritional rehabilitation and who experienced the return of normal menstruation experienced significant increases in bone mineral density. The scientists say this may explain the ineffectiveness of estrogen treatment alone on BMD. The researchers conclude that they now believe nutritional rehabilitation is vital for the return of normal menstruation in anorexia nervosa patients, and that the return of normal menstruation is crucial for full recovery from osteopenia.

Sources:

About.com Eating Disorders Guide; Statistics on Eating Disorders ; Tiemeyer, Matthew. Accessed 07/24/07.

American Journal of Clinical Nutrition; Dominguez et al; Treatment of anorexia nervosa is associated with increases in bone mineral density, and recovery is a biphasic process involving both nutrition and return of menses; Vol. 86, No. 1, 92-99, July 2007. Accessed 07/24/07.

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