Magazine article Clinical Psychiatry News
Oral Contraceptives May Worsen Low Androgen in Anorexia
TORONTO -- Physicians commonly prescribe oral contraceptives for women with anorexia nervosa, but research presented at the annual meeting of the Endocrine Society suggests that androgen levels are already low in these women and are further reduced by the use of oral contraceptives.
But the jury is still out on the long-term consequences for skeletal health and body composition among women with the disease, said Dr. Karen K. Miller of Massachusetts General Hospital, Boston.
Dr. Miller and her colleagues performed a study analyzing androgen levels among 217 community-dwelling women in an effort to determine the physiologic consequences of prescribing oral contraceptives to women with anorexia nervosa.
The study included four arms: 137 women with anorexia nervosa who were not receiving oral contraceptives; 32 with anorexia nervosa who were receiving oral contraceptives; 21 women of normal weight with hypothalamic amenorrhea; and 27 healthy eumenorrheic controls.
Women with anorexia nervosa all met DSM-IV criteria for anorexia nervosa, were less than 85% of ideal body weight, and all had an intense fear of gaining weight or denial of low weight.
Anorectic women not receiving contraceptives had been amenorrheic for at least 3 consecutive months and had not received hormonal contraceptives within the previous 3 months. Anorectic women who received oral contraceptives had to have been receiving them for at least 3 months.
All women with hypothalamic amenorrhea were 90%-110% of ideal body weight; amenorrheic for at least 3 months; had normal FSH, prolactin, testosterone, and free testosterone levels; an LH-to-FSH ratio of less than 2.5; absence of hirsutism; and no history of an eating disorder.
Healthy controls were excluded from the study if they had a history of amenorrhea or an eating disorder, had a history of any major medical illness, or had used oral contraceptives within the last 3 months. …