MedicalResearch.com Interview with:
Madhusmita Misra, MD, MPH
Division Chief, Pediatric Endocrinology
Fritz Bradley Talbot and Nathan Bill Talbot Professor of Pediatrics,
Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Disordered eating behavior is common in conditions of functional hypothalamic amenorrhea, such as anorexia nervosa and exercise-induced amenorrhea, which are also associated with anxiety and depression. In hypoestrogenic rodents, estrogen replacement reduces anxiety-related behavior. Similarly, physiologic estrogen replacement in adolescents with anorexia nervosa reduces anxiety and prevents the increased body dissatisfaction observed with increasing weight. However, the impact of estrogen administration on disordered eating behavior and psychopathology in normal-weight young women with exercise-induced amenorrhea is unknown.
Adolescent and young adult normal-weight athletes 14-25 years old with irregular periods were randomized to receive (i) physiologic estrogen replacement using a transdermal patch with cyclic progesterone, or (ii) an oral estrogen-progesterone containing pill (an oral contraceptive pill), or (iii) no estrogen for 12-months. The Eating Disorder Inventory-2 (EDI-2) and Three-Factor Eating Questionnaire (TFEQ) were administered ag the beginning and the end of the study to assess disordered eating behavior and psychopathology.
We found that the group that did not receive estrogen had a worsening of disordered eating behavior and psychopathology over the 12-months duration of the study, but this was not observed in the group that received estrogen replacement. Further, body dissatisfaction scores improved over 12-months in the groups receiving estrogen replacement, with the transdermal estrogen group showing the strongest effect.
MedicalResearch.com: What should readers take away from your report?
Response: These findings emphasize the importance of normalizing estrogen levels in this population of athletes with low estrogen levels in the context of preventing a further worsening of disordered eating behavior.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies are necessary to confirm these findings in larger cohorts and other conditions associated with low estrogen levels.
No disclosures relevant to this study
Citations: ENDO 2018
Estrogen Administration Improves Disordered Eating Behavior and Psychopathology in Young Female Oligo-Amenorrheic Athletes
Franziska Plessow, Ph.D.1, Vibha Singhal, MD2, Alexander Toth, BA2, Charu Baskaran, MD2, Kamryn T. Eddy, PhD3, Madhusmita Misra, MD, MPH2.
1Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, 2Neuroendocrine Unit and Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, 3Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
March 17, 2018
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