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The Menstrual Cycle and Eating Disorders

By: Beth Morrisey MLIS - Updated: 10 Jun 2018 | comments*Discuss
 
Eating Disorders menstrual Cycle

Eating disorders bring with them the possibility of long-term health effects, and disruption to the menstrual cycle is just one of these possibilities. Particularly with anorexia, low reproductive hormones have been reported in severe cases and the absence of menstrual periods is actually required before this eating disorder can be diagnosed. Though these disruptions won’t necessarily have long-term effects on a woman’s reproductive health, there is also no guarantee that they won’t.

Amenorrhea
One of the diagnostic criteria of anorexia is the loss of the menstrual period for at least three months. This loss is known as amenorrhea. In anorexics, severe weight loss (resulting in weight of at least 15% less than a normal body weight for the woman’s age and height) reduces fat stores in the body which in turn reduce thyroid levels but results in an increase of the stress hormone cortisol. This state, known as hypercortisolism, then reduces reproductive hormones. When reproductive hormones are insufficient to regulate the monthly menstrual cycle, amenorrhea or the cessation of monthly periods occurs.

In the short term, amenorrhea poses few health risks and is usually reversed when weight is put back on, fat is stored in the body and cortisol levels reduce to appropriate levels. In the long-term, however, the low oestrogen levels associated with amenorrhea can cause a woman’s bones to fail to reach proper growth levels or for the woman to develop osteoporosis, a condition in which bone mineral density is reduced and bones become porous and susceptible to breaks. For this reason, if a female reaches a state of amenorrhea medical help should be sought immediately.

Low Reproductive Hormones
Though low levels of reproductive hormones is a feature of the amenorrhea that results from severe weight loss and low body weight, some studies have reported that in 30 – 50% of cases of anorexia, disturbances to the menstrual cycle were present before severe weight loss ever occurred and indeed remained problematic even after weight was put back on. This has led researchers to believe that in fact some menstrual disturbances precede anorexia, though no causal link has been found between low reproductive hormones and resulting eating disorders.

Treating Menstrual Cycle Disruptions and Eating Disorders
Menstrual cycle disruptions, when they occur in relation to eating disorders, are treated as part of a holistic treatment plan. The first things treated in cases of anorexia are any physical health issue. Sometimes this will require hospital or clinic stays. When an anorexic regains some physical health, they general reach a more healthy weight and menstrual cycles often return on their own. Once some physical health is restored, mental health issues can be addressed. Often these treatments include counselling or talk therapy, family counselling, cognitive behaviour therapy (to change food, eating and/or exercise behaviours), the use of support groups or group therapy, and nutritional counselling and planning. Rarely is medication used to treat anorexia unless it is prescribed to treat associated condition such as depression. Some synthetic hormones may be used to supplement naturally lower levels of hormones, but this will always be done under medical supervision.

Further information about menstrual cycle disruptions and eating disorders should be obtained from a GP, private mental health professional or from the Eating Disorders Association and/or National Centre for Eating Disorders.

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Paula - Your Question:
Hi there, I have -on and off- been dealing with Anorexia for nearly 10 years now. What started when I was 15 has now grown into adult restriction! I try SO SO HARD to limit how much I restrict my eating! I really do! I fear carbs, and also fear gaining lots and lots of weight in one time. I am within the 'healthy' weight range at the moment (based on BMI) however at the low end, I have also not had my period for about 3-4 years (I have lost count) unfortunately. I was menstruating in my early 20's however was on the pill. So am un-sure if they were even real periods. I still exercise about 1.5 hours everyday - with light jogging and usually walks. HELP. !!

Our Response:
You would need to speak to someone directly regarding this matter, please see link here and/or here . Talking to someone is the first is your main priority.
EatingDisorderExpert - 11-Jun-18 @ 9:33 AM
Hi there, I have -on and off- been dealing with Anorexia for nearly 10 years now. What started when I was 15 has now grown into adult restriction! I try SO SO HARD to limit how much I restrict my eating! I really do! I fear carbs, and also fear gaining lots and lots of weight in one time. I am within the 'healthy' weight range at the moment (based on BMI) however at the low end, I have also not had my period for about 3-4 years (I have lost count) unfortunately. I was menstruating in my early 20's however was on the pill. So am un-sure if they were even real periods. I still exercise about 1.5 hours everyday - with light jogging and usually walks. HELP.!!
Paula - 10-Jun-18 @ 9:49 AM
@Emma - mine were all over the place. It will take a while to adjust. At least, it means your body is getting healthy again :)
Anna - 19-Feb-18 @ 9:32 AM
Is it possible that my menstruation cycle length changes from one month to the other during recovery? I’ve got back my period in an early stage of recovery and I had it every month almost the same day (just like before my ED), but last month I’ve had a six week cycle and it seems that this is the case this month too...
Emma - 18-Feb-18 @ 1:59 PM
Emma - Your Question:
Please please please stop restricting yourselves. I haven't had a period for 5 years and am now slowly gaining weight back after years of restriction. Once you start eating normally again, you will be SO HUNGRY all the time because your body is desperate for the calories you restricted before. You can't avoid the hunger forever, and when you stop starving yourself, it will hit you like a truck. Life is worth more than feeling dizzy all the time. You need a social life. You will feel so much happier once you start eating more trust me!! I used to isolate myself day in day out because I felt awful all the time. Having the energy to do things you enjoy is so relieving. Get help from anyone you can before things get worse.

Our Response:
We are glad you are on the mend and can offer this advice to others. Best of luck for your future recovery.
EatingDisorderExpert - 12-Jan-18 @ 12:22 PM
Please please please stop restricting yourselves. I haven't had a period for 5 years and am now slowly gaining weight back after years of restriction. Once you start eating normally again, you will be SO HUNGRY all the time because your body is desperate for the calories you restricted before. You can't avoid the hunger forever, and when you stop starving yourself, it will hit you like a truck. Life is worth more than feeling dizzy all the time. You need a social life. You will feel so much happier once you start eating more trust me!! I used to isolate myself day in day out because I felt awful all the time. Having the energy to do things you enjoy is so relieving. Get help from anyone you can before things get worse.
Emma - 9-Jan-18 @ 9:13 PM
See comment below - amenorrhea was removed from the DSM-5 IN 2012! This is so outdated to have been written in 2018 - so many girls who are ‘new’ to this disorder will believe they are too fat to get help because of this website - you should be very aware that is exactly how anorectic brains work, and you could easily have killed thousands who considered help until reading that! The ED medical community has already prevented countless women from getting Care due to this in previous years - at my low meat weight with a BMI of exactly 15, I had my period like clockwork. I lost my period for several months when my disorder began, and my BMI was over 18 - now at a BMI of 16.8, my period isn’t consistent, but still comes monthly (cycle healthy 29-31 days exactly, currently CD begins between day 19 and 43..) please take this down immediately!!! As an ‘expert’ in eating disorders this should have been general knowledge at least 5 years ago. Look at the comments of these young girls talking about their valid disorders trying to understand their periods..I’ve been in treatment with girls at incredibly low BMIs who never stopped menstruating - every BODY is different, which was FINALLY recognized in the DSM-5. Even I, knowing this, with 18 years experience suffering with anorexia, am triggered reading your website into thinking I am not sick enough to get help. Please redo!
Amy - 9-Jan-18 @ 7:19 AM
Amenorrhea is no longer in the DSM as a critreria for Anorexia. It was removed in the latest DSM-V.. this is an important fact.
Lizzie - 2-Jan-18 @ 6:31 AM
Hey I'm 16 years old, 165cm tall and two days ago I reached 45.9kg. I do not eat breakfast or lunch, and I try my very hardest not to snack. I eat a small dinner which I can usually limit by eating slowly and with small mouthfuls at a time, or I can avoid dinner altogether. It comes with a price, extreme dizziness, difficulty walking, talking and breathing, and I've lost my period. After my freakout of being 45.9kg I tried to eat normally for one day, and I'm back to my restricted 47kg. My boyfriend knows all this, and I know he's right in telling me to get help, but I'm sure many of you guys in this feed know what it's like, help just isn't an option in my head. I don't intend stopping this behaviour for 2018; when school is on it's usually the easiest to avoid food. I know this is stuffed up, but any advice is appreciated.
Bails - 29-Dec-17 @ 10:51 PM
I've been suffering from an eating disorder for abouts 3-4 months and I restrict myself to 300-500 calories every day or sometimes a bit more. I usually have 2 meals a day or even 1. A few days ago I was at around 47.8kg (im 5'4) and now I'm at 49.6kg and idk if It's just water weight because of my period because I haven't had it for 31 days and other times 50 days. I recently binged HORRIBLY at my friends house eating 2 sandwiches,1 banana,a couple of mini doughnuts,3 and a half reeces peanut butter cups,6 chicken nuggets and 1 and a half mcdonalds large fries,berry burst mcdonalds smoothie,a couple of very mini sausage rolls,jolly ranchers,half a bag of smurfs haribos and maybe another 400 calories which seems reasonable but I dont think I'd gain all of that?
Niki - 11-Sep-17 @ 12:37 AM
I'm 16 years old, and I went from not eating a lot to not being able to stop what I eat. I had missed my period last year for three months then got it after I got it I missed it again for three months. I then got my period and after that I missed it for three months. I believe that's what's going on right now as well. What's this mean. I never was involved in anything sexual so I know it can't be that. But why is it that is like every three months I'm getting my period? This just started happening last august I'd say. Any suggestions? Thank you!!
Niki nik - 10-Aug-17 @ 4:05 AM
I'm 14 and I lost my period from November 2016 till July 2017. I've been restricting myself to eat less food a day and typically only eat 2 meals a day. I'm also very active and do about 7 hours of intense figure skating a week. I just got my period today and I'm worried that I've started to gain weight now. How can I tell if I have an eating disorder. And is it going away now that my period is back?
SockQueen - 29-Jul-17 @ 9:14 PM
I'm 15 and my boyfriend and I have done some sexual stuff together. I'm suffering with a severe eating disorder (eating between 50-200 calories a day) anxiety and depression. Yesterday I started my period, well I thought I did, but then it stopped and now it's started again; the blood is dark brown and lumpy. All websites on the internet are pointing to that I am pregnant, but I'm not sure if it is my eating disorder affecting it. Any ideas would be graciously appreciated!
Queenana - 14-Apr-17 @ 1:57 PM
Hey, I'm 13 and I have lost my period. My period will be gone six months in a couple of days and I am trying to gain weight but whenever I see myself I think, you don't need to gain weight you need to lose weight! I have been binging a lot lately for like two weeks eating 300-5000 calories a day and I know I'm gaining weight because my pants are getting tighter but I want to go back to restricting and go back to being below 100 pounds. I weighed myself after I ate and it was almost 110. How can I gain that much weight in such little time. From my calculations I should have only gained 6 pounds from my binging. So is it just water weight or fat?
Lexi - 28-Mar-17 @ 12:31 PM
Lily - Your Question:
Hi, I'm turning 15 this month and I haven't got my period for 5 months already. I'm not sure if I have an eating disorder but I never eat breakfast in the mornings except for weekends and I don't eat lunch in school. Often in the week, I will buy ice coffee and won't have anything to eat until I get back home from my job. Almost every day I be having headaches. Is there something wrong with me?

Our Response:
There is a great deal of health-related importance in having a balanced three-meal a day routine. Skipping meals is never advised and this will lead to a number of health problems. If your period has stopped, you may wish to visit your GP for advice.
EatingDisorderExpert - 16-Mar-17 @ 12:03 PM
Hi,I'm turning 15 this month and I haven't got my period for 5 months already.I'm not sure if I have an eating disorder but I never eat breakfast in the mornings except for weekends and I don't eat lunch in school.Often in the week,I will buy ice coffee and won't have anything to eat until I get back home from my job.Almost every day I be having headaches.Is there something wrong with me?
Lily - 15-Mar-17 @ 4:09 PM
Hi,2 years ago I've suffered from anorexia and since then I haven't had my cycle ,I'm turning 15 in 2 months .will that effect my growth?and what should I do ? Thanks
Sara - 16-Feb-17 @ 9:11 PM
Holly - Your Question:
Hi, I am 21 years old and have suffered from an eating disorder for almost 3 years. I was on the pill for majority of this time so was unsure as to weather I still had a 'proper period'. Only recently I have come off the pill and haven't had a period for about 3 months. Is this because I have just come off the pill or could this mean that my period has stopped all together ?! I'm really worried as I just want my period to come back. Should I get this checked out or wait a little longer to see if it returns ?! Not sure what to do.

Our Response:
If you are recovering from your eating disorder and are gaining weight, then your period should return in good time, as every woman is different. However, you don't say whether you are 'recovering' or still have an eating disorder (which if so, it may continue to affect your periods). As a rule though, your periods should begin again almost immediately once you stop taking the pill. Therefore, I think you should see your GP if you are concerned and/or if you need any further advice.
EatingDisorderExpert - 27-Jan-17 @ 11:37 AM
Hi, I am 21 years old and have suffered from an eating disorder for almost 3 years. I was on the pill for majority of this time so was unsure as to weather I still had a 'proper period'. Only recently I have come off the pill and haven't had a period for about 3 months. Is this because I have just come off the pill or could this mean that my period has stopped all together ?! I'm really worried as I just want my period to come back. Should I get this checked out or wait a little longer to see if it returns ?! Not sure what to do....
Holly - 26-Jan-17 @ 3:45 PM
i have a co-worker and a friend that i have worked with for 25 years.She is anorexicand has beed struggling for years.I am concerned now that she told me that after 25 years of not having her period she recently had a coupledays with blood ,clots, and cramps.she is one that will not go into the doctor but waits it out thinking that it will go away.I am wondering if that is something that occurs after so longwith out having the period or what could possibly be going on with her.. Please advice..
jay - 10-Dec-16 @ 4:22 AM
in response to Cj777 - I did not have a period for nearly 4 years when my eating disorder was at it's worst / weight at it's lowest. eventually they do return with weight gain so you will not become infertile although depending on amount of weight gain the periods probably will remain irregular (mine did, I only just fit inside healthy BMI range now)
rosie - 30-Oct-16 @ 12:48 PM
DuckyJnr - Your Question:
Hi, I'm just wondering if there is a certain point with secondary/hypothalamic amenorrhea where you actually become permanently infertile or unable to regain your menses?I have been amenorrhoeic now for nearly 6 years in relation to an eating disorder. I m going to be 30 next year and am getting concerned I still have no sign of getting my cycle back. I have stopped exercising now for over a year apart from walking, my BMI is currently 20, so in the healthy range and I eat healthily. Is there still a chance I could get it back naturally?Many thanks in advance.

Our Response:
With secondary amenorrhea (when periods cease for six months or longer) hormones can be affected as well as the functioning of the thyroid gland and hypothalamus-pituitary-adrenal gland. Even though you may have regained a routine of healthy eating and exercise habits, often periods will not begin again until in addition, the chemical balance in your body is restored. As every case is different, you should really see your GP to seek further advice. I hope this helps.
EatingDisorderExpert - 12-Oct-16 @ 10:10 AM
Hi, I'm just wondering if there is a certain point with secondary/hypothalamic amenorrhea where you actually become permanently infertile or unable to regain your menses? I have been amenorrhoeic now for nearly 6 years in relation to an eating disorder. I m going to be 30 next year and am getting concerned I still have no sign of getting my cycle back. I have stopped exercising now for over a year apart from walking, my BMI is currently 20, so in the healthy range and I eat healthily. Is there still a chance I could get it back naturally? Many thanks in advance.
DuckyJnr - 11-Oct-16 @ 4:20 AM
Ann - Your Question:
Hi, I am an athlete and I exercise about 4 hours a day. I was put on laxatives by my doctor because I did not have regular bowel movements. I am now regular but it is not solid which leads me to believe I am loosing nutrients through that. I have always struggled with not being able to lose weight no matter how hard I try. I have a very healthy habit throughout the day but I have a tendency to overeat unhealthy foods at night like icecream which is very easy to throw up so I have gotten in that habit. I don't want to have stomach issues and I don't want to throw up my food, it makes me feel like I'm weak but it is so hard to have that self control. Any advice would help. Thanks.

Our Response:
I think in this instance you may need to speak with your GP, especially if your doctor has prescribed laxatives and at the same time you are inducing vomiting. It is very easy to slip from something that seems innocent to start with, then into Bulimia Nervosa , which as you may know is an eating disorder that manifests itself through binge eating followed by purging behaviours such as vomiting or taking laxatives, please see link here. At least you are aware of this move, into what can be dangerous territory. Therefore, it is much better to seek help early than leave it until it starts to become increasingly entrenched.
EatingDisorderExpert - 26-Sep-16 @ 10:20 AM
Hi, I am an athlete and I exercise about 4 hours a day. I was put on laxatives by my doctor because I did not have regular bowel movements. I am now regular but it is not solid which leads me to believe I am loosing nutrients through that. I have always struggled with not being able to lose weight no matter how hard I try. I have a very healthy habit throughout the day but I have a tendency to overeat unhealthy foods at night like icecream which is very easy to throw up so I have gotten in that habit. I don't want to have stomach issues and I don't want to throw up my food, it makes me feel like I'm weak but it is so hard to have that self control. Any advice would help. Thanks.
Ann - 25-Sep-16 @ 5:27 AM
Julia - Your Question:
Hi, my name is Julia, and I have been suffering from anorexia for two months. I try to eat but I just can't. I haven't had my period since then. What do I do?

Our Response:
As specified in the article, severe weight loss can reduce reproductive hormones which subsequently affects the monthly menstrual cycle. If you haven't already, you need to seek help for your condition before it becomes entrenched and before it affects other areas of your life and health. Please read the other articles in our series and do other research on the subject. Anorexia as a condition is much more than the desire to lose weight, it comes with very significant pychological and health issues that can impact on your life both now and in the future should you continue on this road.
EatingDisorderExpert - 23-Aug-16 @ 9:49 AM
Hi, my name is Julia, and I have been suffering from anorexia for two months. I try to eat but I just can't. I haven't had my period since then. What do I do?
Julia - 22-Aug-16 @ 8:15 PM
I need some help and advice. I have a co-worker that I suspect has an eating disorder. I have my own issues in the past, I suffer from compulsive eating. Anyway I found out that my co-worker only eats once a day. She also said she's anemic, she left work today early to pick up medication for it. I told her to be careful because I was anemic at one point due to being overweight, and suffered from periods that wouldn't end and the never ending periods caused me to be anemic. I told her that I was on iron tablets and they made me feel sick. She then commented that she goes months without having a period. Needless to say I am concerned and believe she's suffering from a eating disorder. I don't know what to do, how to help her out, or if I dare help her out. I am kind of stumped.
Becca - 6-Aug-16 @ 2:36 AM
Zannie - Your Question:
I had not had any period for 4-5 years, as I have an eating disorder I also have been put on Citalopram Hydrobromide Tablets then I started again a month or 2 later out of the blue I was very shocked and upset but what I would like to now is could this be the cause as I am not recovered from my eating disorder and still low weight?, thank you

Our Response:
The drug can both cause periods to be missed and also cause heavy periods. We could not speculate whether the drug has caused your periods to begin again - you would have to consult your GP regarding this.
EatingDisorderExpert - 1-Aug-16 @ 2:00 PM
I had not had any period for 4-5 years, as i have an eating disorder i also have been put on Citalopram Hydrobromide Tablets then i started again a month or 2 later out of the blue i was very shocked and upset but what i would like to now is could this be the cause as i am not recovered from my eating disorder and still low weight?,thank you
Zannie - 1-Aug-16 @ 12:11 AM
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