Osteoporosis and infertility after anorexia nervosa

Eating disorders: The development of somatic complications observed in pati ents with eating disorders depends both on the duration of the clinical cou rse and on the gravity of the symptoms and psychological factors, it would thus appear advisable to obtain a complete endocrine (gonadotropic, thyroid , hypothalamo-hypophyseal-adrenal) work-up which could be repeated every ye ar after the patient has controlled the behavior disorder. Two aspects of t hese complications predominate: osteoporosis and infertility. Osteoporosis: A common finding after anorexia nevrosa, osteoporosis can lea d to multiple, sometimes spontaneous, fractures. Bone mass can be assessed with biphotonic absorptiometry. The indication for estro-progestogen prophy laxis is debatable, depending on the patient's psychological profile, but a lso because efficacy has not always been demonstrated. Third-generation bip hosphonates appear to offer promising results. Infertility: Among a population of women consulting for infertility, a non- negligible percentage have infraclinical manifestations of anorexia nevrosa . nle question of prescribing estroprogestogens, which would allow normal c ycles and a certain vaginal trophicity, is often raised. We advocate a clos e coordination between endocrinologists, infertility specialists and psychi atrists in order to better define the precise modalities of a given treatme nt aimed at regulating hypothalamo-pituitary function or favoring procreati on.