What is the most common gynecologic symptom of anorexia nervosa?

Amenorrhea is recognized as the most common gynecologic symptom of anorexia nervosa due to the significant hormonal changes and body weight loss associated with the disorder. Anorexia nervosa leads to a state of energy deficiency, which disrupts the hypothalamic-pituitary-ovarian axis, resulting in a decrease in the secretion of gonadotropin-releasing hormone (GnRH). This, in turn, reduces the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), leading to a diminished production of estrogen and the cessation of menstrual periods.

The absence of menstruation, or amenorrhea, in individuals with anorexia nervosa is a reflection of the body’s response to malnutrition and the disruption of normal hormonal regulation. Typically, when the body senses inadequate energy availability, it prioritizes survival functions and reproductive capabilities are diminished as they are not deemed essential under such circumstances. Hence, amenorrhea serves as a physiological signal indicating the serious impact of the eating disorder on reproductive health.

In contrast, lactation, dyspareunia (painful intercourse), and menorrhagia (heavy menstrual bleeding) are not typically associated with anorexia nervosa. Lactation usually occurs post