Estrogen Improves Eating Behavior, Psychopathology in Oligo-Amenorrheic Athletes

In young female athletes with oligo-amenorrhea, estrogen replacement therapy may improve disordered eating behavior and psychopathology by normalizing estrogen levels, according to an abstract presented at ENDO 2018: The Endocrine Society Annual Meeting, held March 17-20 in Chicago, Illinois.¹

Madhusmita Misra, MD, MPH, professor of pediatrics at Harvard Medical School and a pediatric endocrinologist at Massachusetts General Hospital, and colleagues investigated whether 109 normal-weight athletes with oligo-amenorrhea had greater disordered eating behavior and psychopathology compared with 50 athletes with eumenorrhea and 39 non-athletes, and whether 1 year of estrogen replacement therapy would improve those symptoms.

Athletes with oligo-amenorrhea were randomly assigned to receive either a 100-mcg transdermal 17β-estradiol patch with cyclic progesterone, a combined oral contraceptive pill with 30 mcg ethinyl estradiol and 0.15 mg desogestrel, or no estrogen for 12 months.  

Using self-report assessments and questionnaires, the researchers found that athletes with oligo-amenorrhea reported a higher drive for thinness and more mental control over their food intake compared with athletes with eumenorrhea and non-athletes. In addition, they reported higher mean body dissatisfaction scores compared with athletes with eumenorrhea.

After receiving estrogen replacement for 12 months, the athletes with oligo-amenorrhea demonstrated decreases in the drive for thinness, body dissatisfaction, and uncontrolled eating compared with those who did not receive estrogen. The patch was shown to be the most effective treatment, with significant reductions in body dissatisfaction and uncontrolled eating.     

“Our findings underscore the relationship between estrogen and disordered eating behavior, and the potential of estrogen replacement as a treatment target, not just in athletes, but potentially also in other conditions characterized by abnormal eating behavior and frequent menstrual dysfunction, such as anorexia nervosa,” Dr Misra said in a press release.² “More studies are necessary to confirm these findings,” concluded Dr Misra.

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References

1. Plessow F,Singhal V, Toth A, Baskaran C, Eddy KT, Misra M. Estrogen administration improves disordered eating behavior and psychopathology in young female oligo-amenorrheic athletes. Presented at: ENDO 2018: The Endocrine Society Annual Meeting; Chicago, IL; March 17-20, 2018. Abstract SAT-290.
2. Estrogen may reduce disordered eating behavior in female athletes with irregular periods [press release]. Washington, DC: Endocrine Society. Published March 17, 2018. Accessed March 17, 2018.