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The Menstrual Cycle and Eating Disorders

By: Beth Morrisey MLIS - Updated: 11 Sep 2017 | 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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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
Hi, I need help.. I have gone through n a serious case of anorexia and bulimia on and off for 2 years... it's been three years now that I have been a healthy weight and gained a healthy lifestyle and so on... but my period has never returned and has been gone for 3 years... could this mean that I am now infertile
Cj777 - 1-Jul-16 @ 9:16 AM
Tgirl - Your Question:
Hi- I have been struggling with anerexia for 3 months now and am currently in weight restoration. We caught the disease pretty early but my original weight was 123lbs and I dropped to 102lbs in 1 month. I am currently at 119 give or take a pound and have gained that weight in 1month. My weight has begun to plateau, and my therapist says that my body probably won't gain anymore weight. I am doing whatever I can to be my old heathy self, and now I am concerned about my period. The last time I had my period was in February and it is currently end of June. I can't have any dairy products, but have been trying to add extra iron and fat into my diet to help my period return. I eat bacon, nuts, and a lot of red meat as well as taking multi vitamins with extra iron. I was just wondering if there was more I could do to get my period back as fast as possible? Or how much longer it will be before I get my period back because I have been regular ever since I got my period 3 years ago(I am 15 currently)?

Our Response:
As specified in the article, when an anorexic regains some physical health, they general reach a more healthy weight and menstrual cycles often return on their own. I would not worry about the return of your period, your main objective is to maintain your improvement and your period will come of its own accord.
EatingDisorderExpert - 23-Jun-16 @ 12:07 PM
Hi- I have been struggling with anerexia for 3 months now and am currently in weight restoration. We caught the disease pretty early but my original weight was 123lbs and I dropped to 102lbs in 1 month. I am currently at 119 give or take a pound and have gained that weight in 1month. My weight has begun to plateau, and my therapist says that my body probably won't gain anymore weight. I am doing whatever I can to be my old heathy self, and now I am concerned about my period. The last time I had my period was in February and it is currently end of June. I can't have any dairy products, but have been trying to add extra iron and fat into my diet to help my period return. I eat bacon, nuts, and a lot of red meat as well as taking multi vitamins with extra iron. I was just wondering if there was more I could do to get my period back as fast as possible? Or how much longer it will be before I get my period back because I have been regular ever since I got my period 3 years ago(I am 15 currently)?
Tgirl - 22-Jun-16 @ 6:53 PM
Catie - Your Question:
Hiya I've suffered with an eating disorder for about an year and a half now. I lost a significant amount of weight in a short space of time and thys my periods stopped. Behaviours have been very extreme, excessive exercise, laxative abuse, pushing. I started dianette recently (for skin reasons) and immediately got my period for the first time in months and it lasted 12 days despite despite still ingesting the tablet before my eating disorder it being fairly regular. I'm just wondering is this something to do with the prosthetic hormones or is this just a natural phenomenon?

Our Response:
I advise you read the leaflet that comes with your medication, which will give you more information. Dianette does contain ethinylestradiol which is a synthetic version of the naturally-occurring female hormone, oestrogen. Therefore, it will regulate and control your periods. If you need any further advice, you should consult your GP.
EatingDisorderExpert - 4-May-16 @ 11:07 AM
Hiya I've suffered with an eating disorder for about an year and a half now. I lost a significant amount of weight in a short space of time and thys my periods stopped. Behaviours have been very extreme, excessive exercise, laxative abuse, pushing.I started dianette recently (for skin reasons) and immediately got my period for the first time in months and it lasted 12 days despite despite still ingesting the tablet before my eating disorder it being fairly regular. I'm just wondering is this something to do with the prosthetic hormones or is this just a natural phenomenon?
Catie - 3-May-16 @ 1:02 PM
I'm an anorexic. My periods have always been super heavy but regularly timed. Lately, I am having a full week to ten days of bleeding followed by a week to ten days of not bleeding, over and over. I am on oral birth control. This has been going on for about six to eight months. Now I noticed another change: the blood is very light red, almost bright red, and very thin. I have no reproductive system cysts or physical problems. What the HECK is going on? Anorexics often lose their period but none that I know have reported endless periods!!!!
YSanford - 26-Mar-16 @ 10:22 PM
Vicki - Your Question:
Hi. I was bulimic for for 6 years & finally decided to it was time for this to end & start recovery. I haven't purged in 1 & a half months now, but I'm really worried because my period is due & I'm only spotting. When I was actively bulimic I would get it regularly. Any advice would be really appreciated.

Our Response:
We all have irregular periods now and again, either spotting for a couple of days first, or even sometimes missing a month or two. As specified in the article, disturbances to the menstrual cycle may be present before severe weight loss and indeed remained problematic even after weight gain, in terms of anorexia. However, if you have any concerns, or may need re-assurance, or if it continues then I advise you make an appointment with your GP who will talk you through this and other things to help get you back on the road to recovery.
EatingDisorderExpert - 13-Nov-15 @ 10:11 AM
Hi. I was bulimic for for 6 years & finally decided to it was time for this to end & start recovery. I haven't purged in 1 & a half months now, but I'm really worried because my period is due & I'm only spotting. When I was actively bulimic I would get it regularly. Any advice would be really appreciated.
Vicki - 12-Nov-15 @ 4:56 AM
My period is about four days late. I've been recovering from my bulimia for almost two years now. I don't exercise anymore, andI definitely don't vomit as much as I used to. But I still do vomit maybe an average of two times a week. Maybe more. I was wondering if maybe my mild bulimic ways could cause my period to come later? I have been having protected sex with my boyfriend and I'm scared I might be pregnant. I have also been taking ambien, and adderal without a prescription, could that cause my period to be late too? I'm really nervous. Please help.
Jess - 27-Aug-15 @ 10:34 PM
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