How An Eating Disorder Can Damage Your Future Fertility

Conditions like anorexia and bulimia and other disordered eating patterns or obsessive fitness attitudes can wreak havoc not only on our mental health and self-image, but also on our physical health. Though the psychological aspect of these issues is often focused on (and rightly so), eating disorders can even damage our reproductive health and our chances of achieving healthy, successful pregnancies.

Disrupting Our Reproductive Health

The mental health profession’s Diagnostic and Statistical Manual outlines four main categories of eating disorders. Binge eating disorder, a disorder which unlike its other counterparts doesn’t focus on avoiding weight gain but hinges on frequent instances of binging, is actually the most common ED among Americans. Anorexia nervosa focuses on restricted eating as a way to avoid weight gain. Bulimia nervosa utilizes both binging and avoiding weight gain (usually through purging or excessive exercise). The last category, known as selective eating disorder, is often compared to anorexia but doesn’t share the same body dysmorphic attitudes about the individual’s weight.

As with any eating disorder that’s restrictive, a medical or mental health professional’s main concern is that the individual will eventually be severely underweight, both in body weight and body fat. When this occurs, ovulating or getting a period may become irregular or even stop completely. A concerning 70-90% of women suffering from anorexia reported that their periods stopped for at least three months as a result of their ED.

Being underweight can cause you to lose your period or to stop ovulating.

Why does this happen, and why specifically is it a low body weight that triggers this response in our reproductive system? Studies show that anorexic individuals have a lower production of the hormone leptin. Dr. Talia Shirazi explains, “Though it’s typically thought of as the hormone controlling appetite and weight, it has another important superpower: it regulates the activity of the hypothalamus in the brain, which ultimately controls the production of hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH) that are crucial for ovulation. Low levels of leptin can ‘shut down’ the hypothalamus and reduce levels of these important reproductive hormones, resulting in irregular or absent ovulation.”

This makes sense – if we aren’t eating enough for ourselves, then our bodies will interpret it as it’s not safe to get pregnant and will turn off that ability. 

Another common side effect of being underweight is feeling constantly cold and fatigued. This is due to serious glitches in our pituitary gland, which lowers the production of thyroid hormones. The thyroid gland is part of the endocrine system, along with the ovaries, and thyroid dysfunction can negatively interfere with your cycle, ovulation, and reproductive hormone production.

Missing periods and anovulation should be cause for concern at any age. But if these fundamental functions are irregular or have vanished altogether during our childbearing years, then yet another layer of suffering is added to the long and arduous journey of recovery.

Eating Disorders Impact the Entire Functioning of Our Bodies

Aside from the threats to our reproductive health and our mental health, these illnesses take a toll on other important aspects of our physiology.

Women with eating disorders may also understandably suffer from depression and anxiety. Statistically, women do suffer from major depression more often than men, and research shows a connection between decreased estrogen and an increased risk of depression in women. On this basis, scientists have recommended estrogen replacement therapy or even supplemental estrogen to combat this risk – which could lead to increased prescribing of hormonal birth control (which has its own host of potential risks for young women).

Research shows a connection between decreased estrogen and an increased risk of depression in women. 

In teenage girls especially, there’s cause for concern as eating disorders inhibit growth hormones. Fat cells trigger the production of the growth hormone STAT-5 to activate when needed. But when there are no fat cells, there essentially is no growth hormone being activated.

Women who currently live with eating disorders or have lived with them in the past are also more prone to osteoporosis (decreased bone density and mineralization) and lower sodium levels, which can spur seizures and the eradication of electrolytes in the kidneys. While the reproductive effects are concerning enough, it’s evident that eating disorders impact the entire functioning of our bodies, and when one system is in failure, others are likely to follow.

There’s Hope for Recovering Individuals

Fortunately, there is good news. Because being underweight is usually the closest related symptom to absent or irregular menstruation, medical professionals are confident that this issue can be remedied when the body returns to a normal, healthy body weight. It’s also especially important to gain body fat to an acceptable level, since fat helps our bodies function in a number of ways, from prompting it to absorb nutrients to restoring normal body temperature.

It’s also good news that recovering disordered eaters are, in time, relatively able to conceive. A higher number of women (compared to non-disordered eaters) do take six months or longer to achieve a pregnancy, but a successful result is still possible. (However, there are increased risks to pregnancies regarding those still actively suffering from ED, including miscarriage, lower birth weights, and infant mortality.)

Missing periods are usually remedied by returning to a normal, healthy body weight.

Additionally, there are supportive communities out there that actively promote useful and effective resources, both for recovering disordered eaters and for those struggling to get pregnant. It’s possible to “repair” your period, but it does take a certain amount of self-awareness and body literacy, or being in tune with our individual body’s functions. Body literacy can be extremely difficult for those who have suffered in the past from disordered eating, as we’ve intentionally disconnected ourselves from the fundamental aspects of our biology and distorted our own perceptions of ourselves. But that’s what recovery is all about: reclaiming our perceptions, whether good or bad, and owning our struggles in the past while moving forward into healthier futures.

Closing Thoughts

Recovery from an eating disorder is by no means easy. Having been there myself, it’s a grueling process most of us are understandably hesitant to confront head-on.

But the end result speaks for itself. Reclaiming and empowering our bodies – no matter their shape and size, and our distorted or inauthentic views of it – is the ultimate reward, and there’s no greater success than embracing the inner workings of our bodies rather than running from them. 

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