Primary Amenorrhea in an 18-Year Old Patient with Premenarcheal Onset Anorexia Nervosa after Reaching an Appropriate Body Weight

Abstract

Inappropriate body weight loss during early adolescence especially due to anorexia nervosa (AN) and even fear of obesity is known to cause severe endocrinological disturbances, such as delayed puberty and growth retardation. Nevertheless, after achieving adequate weight and then recovering the GH-IGF- I axis, how long menarche is delayed has yet to be elucidated. We herein describe an 18-year old patient with premenarchal onset AN. It took 4 years for her to achieve menarche after attaining an appropriate body weight and recovering her linear growth. We suggest that the hypothalamopituitary-gonadal axis rather than the GH-IGF-I axis could thus be severely damaged by an inappropriate weight loss for several years during early adolescence in association with AN pathophysiology.