Psychoneuroendocrine investigations in 115 cases of female anorexia nervosa at the time of their maximum emaciation

At the time of their maximum emaciation, cases of female anorexia nervosa (AN) were found to present an hypogonadotropic hypogonadism, a low triiodothyronine (13) syndrome, and normal levels of serum prolactin and plasma testosterone. This hypogonadism depended much less on psychological factors (although anxiety seemed to impede the LH release) than on somatic factors: especially on low T3 levels, probably due to restrictive eating behavior, on hypo-estrogenism, on time (which had a slightly favourable effect), and on weight-loss. Weight-loss seems to induce hypogonadism through another mechanism than hypo-estrogenism, probably through a suppression of the LHRH secretion. (However this LHRH suppression could be affected by the long term hypo-estrogenism). An increased opioid activity is not implicated in the hypogonadism at this time. On the contrary, an increased dopaminergic activity seems to partially impede the gonadotropic secretion.