A woman with anorexia nervosa may develop amenorrhea if weight loss is too great. The weight loss is associated with gonadal dysfunction. Menses may begin or resume with successful therapy.

Amenorrhea can be seen in patients with anorexia nervosa. Resumption of menstruation requires adequate nutritional intake.


Target BMI during therapy: 25% BMI percentile for age


A BMI >= 19 kg per square meter was associated with menstruation. The lower the BMI the greater the risk for persistent amenorrhea


Risk factors for persistent amenorrhea:

(1) onset of anorexia prior to menarche

(2) higher premorbid body mass index (BMI)

(3) discharge below target weight

(4) longer hospital stay to reach target weight


A woman with one or more of the risk factors may take a longer than a year to have menses.


If a woman has not started menstruating after reaching the target weight then a higher weight may be needed.

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