Changes in ultrasound appearance of the internal female genital organs during treatment for eating disorders

Abstract Objective: To confirm that changes of the internal female genital organs in patients with eating disorders can be detected with detected with ultrasound and that successive normalization can be followed during treatment. Study design: Thirty-five women with the diagnoses of eating disorders were examined with ultrasound while undergoing psychiatric treatment. The endometrial thickness and ovarian volume were measured. The sonographic picture of the ovaries was classified in four classes. Results: Bulimics had changes of their ovaries in spite being of normal weight. After psychiatric treatment and a normal diet, the ovaries and the bleeding pattern normalized without a change in body weight. In anorectics, undetectable ovaries or ovaries without follicles were associated with low body mass index (BMI), but multifollicular ovaries or presence of a dominant follicle and ovarian volume had no clear relation to BMI. The endometrial thickness correlated with BMI. Conclusion: Ovarian morphology appeared more important than ovarian size. Changes of the ovaries appeared more related to eating patterns than to BMI. Eating disorders should be considered in women with bleeding disorders. Ultrasound examination can contribute to the differential diagnosis.