Bulimia is a mental disorder frequently associated with menstrual disturbances and low estradiol levels. Interestingly, increased androgen (male hormone) levels and polycystic ovary syndrome have also been observed in bulimic women. Little is known about the role of sex hormones in these disorders and researchers speculate that androgens may promote bulimic behavior by influencing food craving and/or impulse control. Now, researchers from the Karolinska Institute in Sweden believe they have established a link between polycystic ovary syndrome, bulimia and levels of the male hormone testosterone. Their research examined the possible association between menstrual disturbances and the occurrence of polycystic ovary syndrome and nutrition related factors predicting bone mass, estrogen signaling in bulimic disease and the effects of an anti-androgenic oral contraceptive on appetite and eating behavior.
They found that bulimics had a higher occurrence of menstrual disturbances, hirsutism and PCOS than women in the control group. Additionally, an association between hirsutism and levels of biologically active testosterone were found in bulimics but not in the control group. They also noted a correlation between two common polymorphisms in the ERā estrogen receptor gene and bulimic disease. Interestingly, treatment with hormonal birth control reduced meal-related hunger and gastric distention in women with bulimia nervosa and improved bulimic behavior in relation to reduced testosterone levels.
The researchers say there appears to be an increased frequency of PCOS in bulimic women and that this endocrine disorder may be of importance for the development of bulimia. It's possible that a genetic variation in the estrogen receptor ERā may play a role in bulimic disease and the researchers suggest that hormonal birth control pills may offer a new strategy for treatment of women with bulimia nervosa not responding to conventional therapy and particularly in those with higher male hormone levels.
Source: Karolinska Institute
