Summary and Outlook
The aim of this symposium was to bring together psychoneuroendocrinologists who study the effects of behavior on reproductive function with basic scientists who study the corresponding neuroendocrine mechanisms. Behavioral alterations have powerful effects on the menstrual cycle. Patients with anorexia nervosa suffer from amenorrhea as long as a severe weight deficit exists (Fichter and Pirke). Fifty percent of normal weight patients with bulimia nervosa, an eating disorder characterized by bingeing, vomiting, and intermittent dieting, also suffer from amenorrhea. Careful analysis of estradiol and progesterone throughout the menstrual cycle has revealed that menstrual cycle disturbances occur more frequently than suspected on the basis of a menstrual cycle history alone; impaired follicular development and luteal-phase defects are common in bulimic patients with apparently normal menstrual cycles. Many patients with eating disorders are heavily exercising. Whether this athletic activity is an additional factor in the development of menstrual disturbances in eating disorders warrants future evaluation. Ballet dancers frequently develop menstrual disturbances as a consequence of heavy exercise in combination with restraint in eating and dieting (Warren). This is not a nonspecific stress effect since, art students living under similarly competitive conditions do not develop amenorrhea and oligomenorrhea.
KeywordsObesity Estrogen Osteoporosis Cortisol Testosterone
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