ABSTRACT
Objective
To predict resumption of menses (ROM) in patients with anorexia nervosa (AN).
Method
Females aged 9–17 years with AN, receiving inpatient multimodal treatment (IMT) or family-based treatment (FBT) underwent assessments at baseline, 6-month and 12-month follow-up (12FU). A menstrual questionnaire recorded date, weight and height at loss of menses (LOM) and ROM occurring up to 30 months after 12FU. A stepwise backward logistic regression analysis evaluated predictors for menstruation at 12FU.
Results
Among 99 females (age = 14.8 ± 1.7) with AN (restrictive = 85 [86%], binge-purge = 8 [8%], atypical = 6 [6%]), and percent median body mass index (%median BMI) = 78.9 [IQR = 74.3, 82.8] undergoing IMT (n = 50) or FBT (n = 49), 66 (66.7%) had at baseline secondary amenorrhoea, 26 (26.3%) were without menarche, 5 (5.1%) had regular menses, and 2 (2.0%) used contraceptives. At 12FU, menses were present in 45 (45.5%) patients and associated with baseline menarche (OR = 6.04, p = 0.002) and higher 12FU %mBMI (OR = 1.08, p = 0.006) (R
2 = 0.251). After an average of 15 months of amenorrhoea [IQR = 12.0, 25.0] (n = 41 with information), %mBMI at ROM (92.0 [IQR = 86.6, 97.8], equalling BMI percentile = 25.0; range = 1–60), was 6.8 %mBMI units > LOM (85.2 [IQR = 79.9, 92.0]; p = 0.001), and 6.5 %mBMI units < premorbid %mBMI (98.5 [IQR = 94.1109.7]; p < 0.001).
Conclusions
ROM follows weight recovery. Full restoration to premorbid BMI percentile is not necessary for ROM.