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Adolescents and young women with functional hypothalamic amenorrhoea: is it time to move beyond the hormonal profile?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To ascertain the role of deranged eating behaviours (DEBs) in the development of functional hypothalamic amenorrhoea (FHA) and the reciprocal role of psychopathological traits on both disorders.

Methods

A prospective case–control study was conducted spanning the period January 2016 to April 2018. Forty-one consecutive FHA females and 86 healthy controls were recruited. We assessed the DEBs and other FHA predisposing factors via self-reported questionnaires. Possible correlations amongst the variables were examined using the Spearman’s correlation coefficient (rho), whilst multivariate logistic regression was carried out to identify independent predictors of DEBs.

Results

Mean scores on Eating Attitudes Test-26 (EAT-26) were significantly higher in females with FHA (p < 0.0001). Women with FHA were characterised by significantly higher scores at the sub-scale items of dieting (p = 0.03) and bulimia and food preoccupation (p < 0.001) compared to healthy controls. Significant difference was also observed between the mean scores of the two groups in all other questionnaires: State-Trait-Anxiety-Inventory (STAI) (p < 0.0001), Multidimensional Body-Self-Relations Questionnaire (MBSRQ) (p < 0.0001) and International Physical Activity Questionnaire (IPAQ) (p = 0.004). EAT-26 scores were positively correlated with scores on STAI (ρ = 0.26, p = 0.04), MBSRQ (ρ = 0.79, p < 0.0001) and IPAQ (ρ = 0.35, p = 0.03). High scores on IPAQ and STAI were correlated with a 12.2-fold (p = 0.008) and 4.3-fold (p = 0.04) increased risk for high scores on EAT-26 respectively.

Conclusions

DEBs may occur in FHA populations at a higher frequency compared to the general population. Anxiety and overweight preoccupation may underlie and independently contribute to development and maintenance of both DEBs and FHA. This evidence may have future implications for both screening and interventions that target DEBs and other psychological factors.

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Funding

We certify that no party has a direct interest in the results of the research and that no benefit will be conferred to us or any organisation with which we are associated.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Guy’s and St Thomas’ NHS Foundation, King’s College, London, UK

    Anastasios Tranoulis, Dimitios Loutradis & Lina Michala

  2. First Department of Obstetrics and Gynecology, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Anastasios Tranoulis

  3. Second Department of Paediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Alexandra Soldatou

  4. Department of Obstetrics and Gynaecology, Chelsea and Westminster NHS Trust, Imperial College, London, UK

    Dimitra Georgiou

  5. Molecular Biology Unit, Division of Human Reproduction, First Department of Obstetrics and Gynaecology, Alexandra Hospital, Athens University Medical School, Athens, Greece

    Despoina Mavrogianni

Authors
  1. Anastasios Tranoulis
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  2. Alexandra Soldatou
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  3. Dimitra Georgiou
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  4. Despoina Mavrogianni
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  5. Dimitios Loutradis
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  6. Lina Michala
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Contributions

Protocol/Project development: AT, LM. Data collection: AT, LM. Data analysis: AT, DG, DM. Manuscript writing/editing: AT, AS, DL, LM.

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Correspondence to Anastasios Tranoulis.

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The authors have no conflict of interest to disclose.

Ethical approval

The study received approval by the Ethics Committee of the University of Athens prior to enrolment (Protocol No 33/131 2016).

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Tranoulis, A., Soldatou, A., Georgiou, D. et al. Adolescents and young women with functional hypothalamic amenorrhoea: is it time to move beyond the hormonal profile?. Arch Gynecol Obstet 301, 1095–1101 (2020). https://doi.org/10.1007/s00404-020-05499-1

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  • DOI: https://doi.org/10.1007/s00404-020-05499-1

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