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Psychological correlates of functional hypothalamic amenorrhea
M D Marcus1, T L Loucks, S L Berga
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. marcusmd@msx.upmc.edu
Objective:
To determine whether mood, attitudes, or symptoms of disordered eating discriminated women with functional hypothalamic amenorrhea (FHA) from those with organic causes of amenorrhea and eumenorrhea.
Design:
Cross-sectional comparison of women with FHA, women with organic amenorrhea, and eumenorrheic control women.
Setting:
Clinical research center in an academic medical institution.
Patient(S):
Seventy-seven women > or =18 years old with time since menarche > or =5 and < or =25 years were recruited by advertisement.
Intervention(S):
Ovulation was confirmed in eumenorrheic control women. Causes of anovulation were carefully documented in amenorrheic participants and LH pulse profiles were obtained to document the diagnosis of FHA. All participants were interviewed and completed questionnaires.
Main Outcome Measure(S):
Self-report measures of dysfunctional attitudes, coping styles, and symptoms of depression and eating disorders.
Result(S):
Women with FHA reported more depressive symptoms and dysfunctional attitudes than did eumenorrheic women, but not significantly more than women with organic amenorrhea. However, women with FHA reported significantly more symptoms of disordered eating than did either anovulatory or ovulatory women.
Conclusion(S):
The findings are consistent with the hypothesis that FHA is precipitated by a combination of psychosocial stressors and metabolic challenge.