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Estrogen Replacement Therapy Lowers Anorexia-Related Anxiety


Individuals diagnosed with anorexia tend to experience symptoms of anxiety and to express dissatisfaction with their body shape when they gain weight. Their bodies also produce less estrogen than normal.

A recent research study reveals that giving estrogen replacement therapy to teenage girls diagnosed with anorexia reduces the anxiety, and leaves young women less concerned about their body’s shape when they gain weight.

“Identification of therapies that reduce the tendency to experience anxiety and reduce body dissatisfaction with weight gain may have a major impact in reducing relapse,” said Madhusmita Misra, MD, MPH, the study’s lead author. “These findings have the potential to impact therapy in anorexia nervosa with early implementation of estrogen replacement in girls who are estrogen deficient.”

The Study

What the researchers noticed was that scores on a standardized anxiety questionnaire fell as the participant’s estrogen levels rose. Plus, if weight gain occurred, the added estrogen seemed to prevent a deterioration of the individual’s attitude about food and her changing body image. This was measured by an Eating Disorders Inventory-II questionnaire.

Seventy-two teenage girls diagnosed with anorexia started this study. They were 13 to 18 years of age when the research began. The girls were randomly assigned either an estrogen placebo or estrogen replacement for a period of 18 months. The questionnaires were given at the beginning and end of the investigation.

The study was completed by 37 of the participants, 20 of whom were on the estrogen replacement. The study’s author, Dr. Misra, is a pediatric endocrinologist and associate professor of pediatrics at Massachusetts General Hospital and Harvard Medical School in Boston, Mass.

About Estrogen

Estrogen, a female sex hormone, is manufactured in the ovaries, testes, placenta and maybe in the adrenal cortex. It is also found in some plants such as soy. This hormone is responsible for the sexual characteristics that distinguish females from males, plays a significant role in the maturing of long bones, and regulates the female monthly cycle.

Investigators have associated estrogen with mood regulation for a long time, but science is just beginning to understand how estrogen plays its role in the modulation of emotion and mood.

Estrogen-Mood Connection

Other research studies have linked low estrogen levels in women to symptoms of anxiety and other mood disorders. It has also been discovered that women are more vulnerable to the effects of trauma and the development of PTSD, when their estrogen levels are low.

One reason the male brain may be generally less prone to mood instability is that testosterone, the male sex hormone, is transformed into estrogen in a man’s brain. When there are high levels of estrogen in the brain, people are less likely to startle or have a fear response.

Misra’s anorexia-estrogen investigation meshes with these other findings.

“This is very important given that anorexia nervosa can be difficult to treat, and underlying anxiety, eating attitudes and concerns of body shape with increasing weight during treatment may reduce the success of treatment programs.”

Sources: Science Daily and Harvard Gazette