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Gynecologic Care for Young Women with Eating Disorders

Obstet Gynecol; ePub 2018 Jun; Sokkary, et al

It is important for obstetricians-gynecologists to recognize signs and risk factors for eating disorders in adults and adolescent females in order for them to gain the appropriate gynecologic care. This according to a new committee opinion from the American College of Obstetricians and Gynecologists (ACOG) that includes the following recommendations and conclusions regarding gynecologic care for adolescents and young women with eating disorders:

  • Adult and adolescent females with eating disorders may present with gynecologic concerns or symptoms, including irregular menses, amenorrhea, pelvic pain, atrophic vaginitis, and breast atrophy.
  • Although formal diagnosis and treatment of eating disorders in adolescents are complex and outside the scope of practice for most general obstetrician–gynecologists, it is important that health care providers be comfortable with recognizing and screening at-risk patients.
  • Recognizing risk factors for eating disorders can help to identify patients who should be further evaluated.
  • Because eating disorders are complex and affect psychologic and physical health, a multidisciplinary approach is imperative.
  • Although obstetrician–gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization.
  • Weight restoration is the best treatment for low bone mineral density (BMD) caused by disordered eating.
  • Further research is needed to define best practices, including management of low BMD, menstrual irregularities, and pregnancy prevention.
  • ACOG recommends against the use of combined oral contraceptive pills (OCPs) solely for the treatment of amenorrhea associated with eating disorders.

Citation:

Gynecologic care for adolescents and young women with eating disorders. ACOG Committee Opinion No. 740. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;131:e205–13.