How Do Eating Disorders Affect Fertility?

Many disorders may be associated with infertility. Women of childbearing age suffering from EDs like anorexia or bulimia may have irregular menstrual cycles, hormonal abnormalities, and ovulatory dysfunction, and may be at higher risk of developing polycystic ovarian syndrome (PCOS). 

An eating disorder results in a lower body mass index (BMI) (2), which may affect pre-pregnancy obstetric outcomes and potential health complications in the future child. All women who have had or are currently suffering from an eating disorder should get medical care prior to their pregnancy. 

Certain eating disorders might induce irregular periods, which affect ovulation and cause hormonal imbalances that disturb the entire reproductive process. Following are some eating disorders that affect fertility.

1. Anorexia nervosa is characterized by an obsession with weight loss and thinness due to excessive food restriction. 
2. Bulimia nervosa is when people binge but purge afterward by vomiting, exercising, or laxative and diuretic usage.
3. Purging disorder, recurrent self-induced vomiting to influence body shape and weight without binge eating.
4. Binge eating disorder, rapidly eating a large amount of food within a short time.
5. Obesity is commonly associated with binge eating. 

How Does an Eating Disorder Affect a Person’s Fertility Levels?

Severe weight loss or weight gain in women can cause menstrual abnormalities and low estrogen levels, damaging the uterine lining and making it harder for a fertilized egg to implant. Men may experience ejaculation problems, and nutritional deficiencies may impact their sperm production. 

As an outcome of an eating disorder, the body lacks important nutrients due to restrictive eating or excessive exercise, disrupting hormone levels critical for reproductive health (3). 

Infertility is routinely seen in individuals going through eating disorders.

Even if these malnourished women become pregnant, they are more likely to experience complications such as:

• Low maternal weight increase
• Anemia
• Cardiac irregularities, 
• Gestational diabetes, 
• Labor complications,
• Birth defects, 
• Premature birth, 
• Low birth weight infants, and 
• Psychological complications like postpartum depression.

For a healthier reproductive journey, eating disorders can be handled by focusing on physical, emotional, and psychological well-being under the care of skilled doctors. 

People who follow a calorie-deficit diet for an extended period may notice that their body’s normal functions begin to shift, affecting their reproductive system during their journey to parenthood.

Are There Any Treatments Available for Eating Disorders to Help with Infertility Issues?

Yes, specific therapy under the supervision of competent professionals can improve the fertility of those suffering from eating disorders. EDs are treatable and respond favorably to individually tailored regimens. 

The most common treatments for eating disorders include:

• Time-limited cognitive-behavioral therapy (CBT-ED) (4)
• Interpersonal psychotherapy (IPT-ED) (5)

Individuals recovering from any form of eating problem should receive personalized nutrition advice that addresses their specific dietary concerns to improve their general health and well-being. In addition, specialized therapy sessions with reproductive professionals try to address their fertility concerns. 

What Are The Long-term Effects of an Eating Disorder on Fertility?

The long-term repercussions of eating disorders that affect fertility have a major influence on both men’s and women’s reproductive health. 

Malnutrition and excessive weight fluctuations caused by eating disorders can jeopardize reproductive health for both genders, limiting the capacity to establish and maintain a healthy pregnancy. 

There is a risk of decreased responsiveness to fertility treatment and increased rates of infertility as a result of hormonal imbalance-induced overweight and obesity. 

•   Women’s irregular menstrual cycles, disturbed ovulation, and low estrogen levels can all make it difficult to conceive.
•   For men, the disease may cause hormonal imbalances that reduce sperm production and quality.

Extreme and extended caloric restriction, which is frequent in eating disorders, can induce malnutrition and irregular menstrual periods in women, affecting fertility by inhibiting ovulation and increasing the risk of miscarriage. Without ovulation, it is impossible to conceive. Malnutrition in men can lower testosterone levels, sperm count, and sperm motility, reducing fertility.

FAQs

1. Is It More Difficult To Get Pregnant With An Eating Disorder?

It may be difficult to get pregnant with an eating disorder but it is not impossible.  Seeking prompt treatment from a healthcare team is crucial for addressing eating disorders both before and during pregnancy. Personalized therapy can help patients manage the risks associated with pregnancy.

2. Can Infertility Be Cured?

Infertility can be managed with lifestyle modifications, medication, assisted reproductive technology (ART), and surgery. However, the root cause of infertility must be addressed before a person can conceive.

3. Can Underweight Cause Infertility?

Underweight women may have lower nutrient storage as a result of unhealthy eating habits, placing them at risk of not gaining adequate weight when pregnant. As a result, underweight women should consult a doctor about weight maintenance before becoming pregnant.

Reference

1. Social Media Use and Body Image Disorders: Association between Frequency of Comparing One’s Own Physical Appearance to That of People Being Followed on Social Media and Body Dissatisfaction and Drive for Thinness – [https://pubmed.ncbi.nlm.nih.gov/33799804/]
2. Body Dissatisfaction, Eating Styles, Weight-Related Behaviors, and Health among Young Women in the United States – [https://pubmed.ncbi.nlm.nih.gov/36145252/]
3. The Impact of Eating Disorders on Reproductive Health: Mitigating the Risk – [https://www.psychiatrist.com/pcc/impact-eating-disorders-reproductive-health-mitigating-risk/]
4. Cognitive Behaviour Therapy for Eating Disorders (CBT-E) – [https://www.eatingdisorders.org.au/storage/2021/03/Cognitive-behaviour-therapy-for-eating-disorders.pdf]
5. Interpersonal Psychotherapy for Eating Disorders – [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886290/]