FAQ: Can eating disorders make you infertile?

The answer is yes. Eating disorders can make a woman infertile in a number of ways. Women with bulimia who have irregular, or absent, menstrual periods often stop having periods altogether due to the stress of having an eating disorder on top of hormonal imbalances. In addition, stress can suppress ovulation by raising levels of the stress hormone cortisol in the body by starving themselves and reducing their weight.

Eating disorders can lead to female infertility in a number of ways. Many women with bulimia have irregular, or absent, menstrual periods. Some women even stop having periods altogether. This is due to the stress of having an eating disorder on top of hormonal imbalances that can result from starvation and bingeing.

Stress can also suppress ovulation by raising levels of the stress hormone cortisol in the body.
By starving themselves, both anorexic and bulimic women can lose so much weight that they have difficulty producing healthy eggs and getting pregnant if they want to conceive a child.

Types of eating disorders

Anorexia is characterized by the refusal to maintain a minimally normal body weight and a fear of gaining weight.

Bulimia is characterized by frequent episodes of binge eating followed by inappropriate compensatory behavior (purging, fasting, or excessive exercise).

Binge-eating disorder is characterized by recurrent binge eating without the regular use of compensatory behaviors characteristic of bulimia nervosa or anorexia nervosa.

Bulimia Nervosa is a serious, potentially life-threatening eating disorder. It begins with binge eating—a feeling of being unable to stop yourself from overeating—followed by a sense of guilt or shame. Because you fear social rejection or weight gain, you try to compensate with several different behaviors. Most people associate bulimia with bingeing and purging, but there are other types of compensatory behaviors that people with bulimia use to maintain a body weight at which they feel comfortable. These behaviors include fasting, exercising excessively, vomiting and taking laxatives to try to speed the digestive process.

Anorexia Nervosa is characterized by longstanding restriction of food intake in a way that is not culturally sanctioned (i.e., only eating certain foods) or physically unmanageable (i.e., leading to significant weight loss). This may be accompanied by distorted body image and an obsessive fear of gaining weight. These thoughts make it difficult to maintain an active and normal lifestyle and can lead to very serious medical problems.

Binge-eating disorder is characterized by recurrent episodes of binge eating (eating larger amounts of food in discrete time periods) associated with the development of compensatory behaviors such as purging, fasting, vomiting or excessive exercise. Despite not meeting full criteria for any diagnosis, this condition is included in the DSM III-R (Diagnostic and Statistical Manual of Mental Disorders) under the heading Obsessive Compulsive Disorder.

Effects of Eating Disorders on Fertility

A key feature of eating disorders is their effect on the female reproductive system, including menstrual function and fertility.

Eating disorders can have an impact on your ability to become pregnant. Some people feel that by using a contraceptive before trying to get pregnant you may put yourself at risk for having an eating disorder again (and then have pregnancy complications) or may put your potential baby at risk from developmental problems.

Restrictive eating patterns may lead to a low body weight and unhealthy condition for menstruation to occur effectively and fertility to be achieved.

One study found that among women hospitalized for anorexia nervosa, ovarian dysfunction (primary ovarian failure) occurred in 50% of cases (N=20).

In one study, 30% of women with eating disorders were found to have hypogonadotropic hypogonadism. In this situation, the ovary does not respond to normal gonadotropin stimulation.

It appears that a very low body weight is required for an eating disorder to lead to primary ovarian failure and infertility.

What Are The Solutions

  1. Ovarian stimulation for the purpose of the occurence of menstruation may be carried out in women with eating disorders, under certain circumstances.
  2. Some women with eating disorders are able to ovulate and menstruate without assistance, but they need to be monitored carefully for other complications related to their eating disorder and their general health status as well as the length of their menstrual cycles.

3.The treatment of infertility in women with anorexia nervosa is difficult and challenging.

What Are The Complications of Infertility in Women with Eating Disorders

  1. The following are the most common complications related to infertility in women with eating disorders:
  2. Some associated complications include:

The effects of eating disorders on fertility are serious. There is a high risk for sexual dysfunction, menstrual irregularities and even infertility for women who have an eating disorder. A normal reproductive system is required for pregnancy to occur and then maintain. If an eating disorder causes a woman’s reproductive system to malfunction, then it is quite possible that she will experience infertility.

Research has shown that women who suffer from eating disorders are more likely to have menstrual irregularity and infertility than women who do not have an eating disorder. There are several factors that are thought to be related to the higher risk for infertility in women with eating disorders, including low body weight, malnutrition, physical inactivity, hormonal dysfunction and altered hypothalamic-pituitary function.

A review of studies on eating disorders and infertility concluded that the most likely cause of the increased risk for infertility related to anorexia nervosa is a combination of low body weight and menstrual irregularity. Women with anorexia nervosa are known to be at a much higher risk for complications during pregnancy and many women with this disorder go through a period of amenorrhea. There is also considerable evidence that low body weight is related to hormonal disturbances in the hypothalamic-pituitary-ovarian axis.

A recent study examined the effect of anorexia nervosa on reproductive function in adolescent girls. The results indicated that menstrual irregularity was common among these young women. Despite this, 30% of the subjects were found to have a normal menstrual cycle and fertile ovulation. Women with restrictive eating disorders who try to lose weight do not typically end up becoming severely underweight. Most maintain a body weight that is within the normal range for reproductive function. Women who are underweight may have an increased risk of infertility due to amenorrhea and hypoestrogenism, but most of the studies that were reviewed showed no connection between low body weight and reduced fertility.

The results of a study suggest that weight restoration in women with anorexia nervosa leads to spontaneous recovery of gonadotropin secretion and ovarian follicular development.