Amenorrhrea in Anorexia Nervosa: Etiology and Implications.

Amenorrhea is one of the necessary criteria for diagnosis of anorexia nervosa in female adolescents, but its exact pathophysiology remains controversial. Involvement of hyperthalamic dysfunction may be due to malnutrition or to an underlying neurotransmitter abnormality. The association of anorexia nervosa with both osteopenia and hypoestrogenemia gives clinical and therapeutic significance to an understanding of the underlying pathophysiology. The authors base recommendations for intervention on the current state of knowledge.