Menstrual cycle irregularity in bulimia nervosa - Associated factors and changes with treatment

Objectives: This study determined the clinical and nutritional variables as sociated with menstrual disturbance in women with bulimia nervosa (BN). Met hods: Eighty-two women with DSM-IV BN underwent psychiatric, nutritional an d menstrual related assessments prior to an outpatient treatment programme and at 12 months follow-up. Results: Forty-five percent reported a current irregular menstrual cycle. A high frequency of vomiting, low thyroxine conc entrations and low dietary fat intake were independently associated with ir regular menses at pretreatment. At 12 months follow-up, 30.5% reported irre gular menstrual cycles, A greater difference between past maximum and minim um body weight, smoking and depression were associated with menstrual irreg ularity at 12 months follow-up. Of those with irregular menstrual cycles at pretreatment, 56.8% became regular at 12 months follow-up. Conclusion: Men strual irregularity in BN is associated with indices of nutritional restric tion that are not reflected by low body weight or energy intake. Depression , cigarette smoking and fluctuations in body weight may act as metabolic st resses that contribute to the perpetuation of menstrual disturbances. (C) 2 001 Elsevier Science Inc. All rights reserved.