Slender, thin girls are gaining popularity in the modern world of beauty and fashion. The desire to lose weight often has no boundaries, which leads to the exhaustion of girls. On this basis, in addition to anorexia nervosa, amenorrhea also develops. It is enough to lose from 5 to 13% of body weight to stop menstruation.
Why does amenorrhea develop with weight loss? How to identify the cause of amenorrhea and treat the absence of menstruation, read on estet-portal.com.
Mechanism of development of amenorrhea after weight loss or starvation
With malnutrition or starvation, the secretion of gonadotropic hormones decreases. The mechanism of development of amenorrhea is the violation of neuroendocrine control of the secretion of gonadotropic releasing – hormones. At the same time, the production of gonadotropins in the pituitary gland decreases.
Therefore, this form of secondary amenorrhea refers to hypogonadotropic. Significant importance in the pathogenesis belongs to the reduction of adipose tissue in the body, which is the site of extragonadal synthesis of sex hormones. So, a sharp loss of body weight leads to the absence of menstruation both during puberty and after it.
No period – first sign of excessive weight loss body
Absence of menstruation is the first sign of adherence to a strict diet, which makes a woman turn to a gynecologist. At the same time, dieting or fasting is carefully hidden by many patients, which leads to the appointment of combined oral contraceptives in order to establish the menstrual cycle. Naturally, this does not bring any effect, but makes the condition even worse.
Therefore, in the presence of amenorrhea, it is important to clarify with the patient when, what, how and in what quantities she eats, as well as pay attention to other signs of starvation or diet. These signs include: bradycardia, hypotension, pallor and dryness of the skin, general weakness, decreased hemoglobin, hypoglycemia, gastritis, constipation, hypothermia.
In addition to these symptoms, patients with no periods on the background of diets often have impaired psychology and behavior regarding the procedure for eating, there is an obsession with losing weight. It is much easier to perform a diagnostic search when a woman adequately assesses her condition and behavior, which happens with a sharp weight loss due to stressful situations.
Difficulties in diagnosing amenorrhea after weight loss
In the diagnosis of the cause of amenorrhea, the main thing is to determine the coincidence in the chronology of weight loss and the absence of menstruation.
In laboratory analyzes of such patients there will be a decrease in the amount of estradiol, LH, FSH. The test with gestagens and estrogens is always positive. The test with gonadotropins contributes to the normal growth and maturation of the follicles, which is regarded as a normal ovarian response to stimulation. The test with GnRH proves the hypothalamic genesis of the pathology.
With instrumental methods of examination for amenorrhea on ultrasound, the ovaries are of normal size, the endometrium is less than 5 mm thick, the uterus is reduced in size.
Amenorrhoea due to fasting requires monitoring and treatment
The treatment of amenorrhea after weight loss is through a balanced diet. Meals should be at least 5-6 times a day. Food should be high-calorie and easily digestible. At the same time, vitamins of group B, E and multivitamins are prescribed for the complex treatment of amenorrhea.
Restoration of the menstrual cycle is possible only with weight gain and depends on the amount of weight loss and the duration of amenorrhea. On average, the cycle resumes 6-8 months after the normalization of body weight.
If there is no effect after normalization of body weight, hormonal natural preparations of gestagens and estrogens are prescribed, which stimulate the hypothalamic structures. Ovulation stimulation is also carried out after the normalization of body weight under ultrasound control.
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