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SEA ISLAND, GA. -- Eating disorders should top the diagnostic list whenever a teenage girl presents with amenorrhea.
Alterations in diet can have "unbelievable" impact on the adolescent menstrual cycle, Dr. Ann J. Davis said at an ob.gyn. meeting sponsored by the Medical College of Georgia.
In a study of 13 young women who ovulated normally and were placed on an 800-calorie vegetarian diet, 7 became anovulatory within only one cycle, she said.
Every adolescent patient with a menstrual disorder, therefore, should be checked for height and weight as well as pulse, blood pressure, temperature, and cardiac rhythm. "If you just do those things, you'll catch the majority of those who are going to die before they get to another physician," Dr. Davis said.
Anorexia nervosa is associated with a 5% mortality and is the third most common chronic disease in female adolescents with a prevalence of 0.5%-1%.
The onset of anorexia in patients has tended historically to be bimodal, either in the early or late teens, "but we've started seeing it in ...