Clinician practices assessing hypothalamic–pituitary–gonadal axis suppression in adolescents with an eating disorder

Lance R. Nelson, Bonnie L. Halpern-Felsher, Jason M. Nagata, Jennifer L. Carlson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: Although extensive literature exists on hypothalamic–pituitary–gonadal (HPG) axis suppression in females with an eating disorder, there are few studies in males. Our study aimed to determine clinician practices for the assessment of HPG axis suppression and to identify differences in practice based on the sex of the patient. Method: Our 31-item survey queried clinicians about confidence level and practices for assessing HPG suppression in male compared to female patients. Results: Findings showed that clinicians (n = 104) were less likely to evaluate HPG suppression in males compared to females, including assessment of sexual maturity rating (p <.050), screening of decreased libido compared to amenorrhea (p <.001) and lab assessment (luteinizing hormone and follicular-stimulating hormone: p <.001; estradiol/testosterone: p <.010; TSH: p <.050). Participants also felt less confident evaluating male patients (p <.001) and requested better screening tools for males (p <.001). Discussion: Our data suggest that clinician practices differ based on patient sex and that clinicians request tools for HPG suppression assessment in males. This is the first study examining specific practices and comfort levels of clinicians when assessing HPG axis suppression. Findings suggest that more guidance on the management of male patients may be needed to standardize care and to prevent short and long-term sequela of malnutrition.

Original languageEnglish (US)
Pages (from-to)2218-2222
Number of pages5
JournalInternational Journal of Eating Disorders
Issue number12
StatePublished - Dec 2021


  • adolescent
  • clinician comfort
  • clinician practices
  • eating disorders
  • hypothalamic–pituitary–gonadal axis
  • males
  • screening
  • sex differences

ASJC Scopus subject areas

  • Psychiatry and Mental health


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