The Influence of Estrogen Therapies on Bone Mineral Density in Premenopausal Women with Anorexia Nervosa and Amenorrhea

Jocelyn Lebow, Leslie Sim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Low bone mineral density is one of the primary risks of chronic amenorrhea, and the effects of potentially long-term menstrual disruption on bone mass are serious concerns for individuals with a past or current anorexia nervosa (AN) diagnosis. As such, estrogen therapies are frequently used to address amenorrhea associated with AN. A systematic review of the literature was conducted to examine the effectiveness of estrogen therapies on bone mineral density in women with amenorrhea. Data regarding the effectiveness of oral contraceptives were of low quality and mixed, with the majority of studies finding no benefit of these treatments on bone mineral density. Hormone replacement therapy findings were also mixed, though promising results were found in a study comparing transdermal administration of physiologic estrogen, delivered in developmentally sensitive incremental doses to placebo controls. Though this study suggests a possible role for estrogen therapies in addressing bone density loss in women with AN, in general, more studies are needed. Clinical drawbacks of using these therapies in the treatment of AN, including the loss of menses resumption as a clinical marker for weight and nutritional rehabilitation, must be considered in the decision to use estrogen therapies, particularly given the uncertain effectiveness of most of these treatments.

Original languageEnglish (US)
Pages (from-to)243-256
Number of pages14
JournalVitamins and Hormones
Volume92
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Anorexia Nervosa
Amenorrhea
Bone Density
Estrogens
Therapeutics
Cutaneous Administration
Menstruation
Hormone Replacement Therapy
Oral Contraceptives
Rehabilitation
Biomarkers
Placebos
Weights and Measures
Bone and Bones

Keywords

  • Anorexia nervosa
  • Bone mineral density
  • Hormone replacement
  • Oral contraceptive

ASJC Scopus subject areas

  • Endocrinology
  • Physiology

Cite this

The Influence of Estrogen Therapies on Bone Mineral Density in Premenopausal Women with Anorexia Nervosa and Amenorrhea. / Lebow, Jocelyn; Sim, Leslie.

In: Vitamins and Hormones, Vol. 92, 2013, p. 243-256.

Research output: Contribution to journalArticle

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