Palabras clave
Ciclo menstrual;
Neurotransmisores;
Gonadotropinas
Anorexia nerviosa
Bulimia nerviosa
Cómo citar
Resumen
Las alteraciones que se agrupan como trastornos de la conducta alimentaria (TCA), son entidades conductuales-neuroendocrinas que generan importantes consecuencias médicas y tienen criterios bien establecidos. El objetivo de esta revisión narrativa es identificar las bases fisiopatológicas, los neurotransmisores y los mediadores hormonales que influyen en la disrupción del funcionamiento del eje hipotálamo-hipófisis-ovario-endometrio que subyace en las mujeres con TCA. Se identificó que en los TCA existen disfunciones en los sistemas de neurotransmisión adrenérgico, colinérgico, serotoninérgico, GABAérgico, glutamatérgico y dopaminérgico. Simultáneamente, a consecuencia de la adopción de patrones alimentarios patológicos, existe disponibilidad energética corporal reducida y modificación en el funcionamiento del eje hipotálamo-hipófisis-adrenal, de la oxitocina y de la acción central, gonadal y periférica de la hormona del crecimiento. Entre las expresiones clínicas derivadas de los TCA, están las irregularidades menstruales, oligomenorrea y amenorrea hipotalámica, que son secundarias al hipoestrogenismo funcional y adaptativo. A su vez, la disminución estrogénica y el desequilibrio endocrino son elementos perpetuadores de los TCA y de sus consecuencias psicobiológicas. En coherencia con el desempeño de los elementos fisiopatológicos que articulan la reducida disponibilidad energética corporal y las modificaciones neurobiológicas con el hipoestrogenismo, se deben manejar inicialmente los factores psicosociales disparadores de los TCA. El enfoque multidisciplinario debe buscar la restauración de las reservas corporales de energía, reducir el estrés y modificar los hábitos alimentarios. A medida que se alcanza lo anterior, se rompe el circulo anómalo endocrinológico, se restaura la actividad neurobiológica y finaliza el estado de hipoestrogenismo funcional y subsecuentemente se regularizan los ciclos menstruales.
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