A survey of knowledge and clinical practice of Anorexia nervosa with amenorrhea among Palestinian gynecologists
A Cross sectional design
Alkaissi A, Shadid A, Khader R
Nursing and Midwifery Department
Faculty of Medicine & Health Sciences
An-Najah National University, Nablus-Palestine
Introduction: Anorexia nervosa (AN) affects many women in their adolescence. One of the diagnostic criteria of the disease is menstrual irregularity, and the presence of a menstruation is used as a sign of recovery among patients. For this reason, these girls intend gynecologists to solve this problem.
Aims: was to evaluate knowledge and clinical practice of Palestinian gynecologists for patients with anorexia nervosa.
Method and materials: a cross-sectional study design, questionnaires were distributed to 60 Palestinian gynecologists 40/60 (66.7%) men and 20/60 (33.3%) women, aged between 30-60 year in the West Bank in Palestine.
Results: AN is unusual disease in our society, 40/60 (67%) of participants thought that the presence of the disease less than 1%, 12/60 (20%) 1-5% and 4 / 60 (7%) is more than 5% respectively. Although 45/60 (75%) of participants felt that teenagers (14-19 years) has the highest percentage of developing the disease. 25/60 (42%) of those gynecologists always check the women's weight during the evaluation of amenorrhea. 18/60 (30%) of gynecologists would administer progesterone to have a withdrawal bleed for 16 - years as a suspect had one, and amenorrhea of three months, 7 / 60 (12%) would administer 20 micrograms, COC, 7 / 60 (12%) would give a 30 mcg COC pill and 27/60 (45%) would not manage anything. 35/60 (58.3%) they thought the causes of amenorrhea in girls of anorexia nervosa is weight loss, stress and fat adipose loss. 29 (48.3%) of gynecologists thought that treatment with combined oral contraceptives reduces the risk of osteopenia in women with AN and should be used , 45/60 (75%) of gynecologists did not do referral to psychiatric specialist for women that present with secondary amenorrhea, 37/60(62%) do make nutritional consult for women that present with secondary amenorrhea, compared with 22/60 (37%) do not make any nutritional consult and 33/60 (55%) would like to know more about anorexia nervosa.
Conclusion: Gynecologists have enough knowledge about AN issue, they are performing a good clinical practice in dealing with AN and they are looking for additional information to identify and refer patients at an early stage of the disease.
Key words: eating disorder, anorexia nervosa, amenorrhea and DSMIV diagnostic criteria.