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Hypothalamic dysfunction in secondary amenorrhea associated with simple weight loss.

R A Vigersky, A E Andersen, R H Thompson

    The New England Journal of Medicine
    |November 24, 1977
    PubMed
    Summary

    Simple weight loss can cause hypothalamic dysfunction, affecting thermoregulation and hormone release. These endocrine system changes are similar to, but less severe than, those seen in anorexia nervosa.

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    Area of Science:

    • Endocrinology
    • Neuroendocrinology
    • Human Physiology

    Background:

    • Secondary amenorrhea is often linked to hypothalamic dysfunction.
    • The specific impact of simple weight loss, distinct from anorexia nervosa, on endocrine function requires further elucidation.

    Purpose of the Study:

    • To investigate hypothalamic, pituitary, and endocrine system function in patients with secondary amenorrhea due to simple weight loss.
    • To assess the correlation between the degree of weight loss and the observed functional abnormalities.

    Main Methods:

    • Evaluated hypothalamic-pituitary-endocrine function in 19 patients with secondary amenorrhea and simple weight loss.
    • Assessed thermoregulation, partial diabetes insipidus, and hormonal responses (luteinizing hormone, thyrotropin) to releasing factors.

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  • Correlated physiological and hormonal changes with percentage below ideal body weight.

    • Main Results:

    • Abnormal thermoregulation was observed and correlated with weight loss.
    • Partial diabetes insipidus was diagnosed in 27% of patients.
    • Delayed peak luteinizing hormone and thyrotropin levels were noted, correlating with weight loss.
    • No significant prolactin, pituitary, thyroid, or adrenal abnormalities were found.

    Conclusions:

    • Weight loss itself can induce hypothalamic dysfunction, leading to endocrine abnormalities.
    • These effects are qualitatively similar to anorexia nervosa but less pronounced.
    • The findings suggest that weight loss is a direct cause of hypothalamic dysfunction.