Eating disorders are linked with fertility – or infertility – issues. Even women who have conquered their eating disorder and/or tendency towards obsessive exercise, and who work hard to manage a healthy lifestyle, may find fertility compromised by their former lifestyle.
The good news is that the combination of meticulous and compassionate self-care, and the help of a fertility specialist, eating disorder-related fertility issues can be overcome. It’s also important to note that men with eating disorders can also experience male infertility factors as a result of malnutrition and/or severe fluctuations in weight.
Perhaps one of the most critical pieces of advice we can offer if you have had an eating disorder in the past, or if you currently have an eating disorder, is to be completely honest with your OB/GYN and/or primary physician. You should certainly be honest about it if you’re already working with a fertility specialist. This information will help to shape the type of care you receive and the information provided as you navigate the road towards pregnancy and parenthood.
Most Eating Disorders Affect Ovulation
Your BMI (body mass index) is one of the first things an OB or fertility specialist will evaluate when you’re having trouble conceiving. A healthy BMI for conception ranges from about 18.5 to 24.9. You can Click Here to get an idea of your current BMI.
Both men and women are at risk for infertility factors when their BMI jumps from overweight to “obese.” On the flip side, having a BMI that is under 18.5 is no good either. At this “underweight’ range, a woman’s body might stop ovulating, indicated by skipped or irregular periods. If you aren’t ovulating, you can’t be pregnant. Women who are overweight also experience hormonal imbalances that can affect fertility, as do men who are obese.
Stress is also a factor. Increasing studies are correlating elevated stress hormones and infertility. The combination of physical stress caused by an eating disorder – combined with the mental/emotional stress that leads up to and is a result of an eating disorder – may also challenge your ability to conceive or carry a baby full-term.
Eating Disorders Can Compromise Fertility Years After You’ve Recovered
Perhaps one of the most surprising things to learn is that infertility can be an issue even years after a woman has gained control over the situation. This is because the brain and body work in a very delicate, choreographed harmony. The physical, mental and emotional stress caused by an eating disorder – combined with starvation/malnutrition – can cause hormonal imbalances that linger well after the situation is under control.
These hormonal imbalances most often cause problems with ovulation, which results in difficulties getting pregnant. The good news is that the larger majority of women will find the restoration of a healthy diet and healthy BMI results in regular ovulation cycles again.
What Happens if I’m Infertile as the Result of an Eating Disorder?
The first step for most women seeking fertility assistance as the result of an eating disorder will be to eat a healthy, well-rounded diet and to establish a normal BMI. Counseling may also be recommended if you are still in the throes of the mental and emotional upheaval associated with an eating disorder. These can include things like anxiety, issues around body image, a strong desire to be in control, perfectionism and so on. Working through these states of mind and being now will help you to enjoy your pregnancy as well as the very imperfect and difficult-to-control upheaval that will take place once baby is born!
Once these basics are put into place, and assuming you’re 34-years or younger, your doctor will make sure you understand how to time conception at home and then wait for the natural, positive pregnancy results to take place on their own.
If you are 35-years old or more (which makes it harder to conceive with or without an eating disorder), or if you aren’t able to get pregnancy using timed intercourse within the first six months, your doctor will begin recommending fertility treatments. Most often, that will commence with Clomid, an oral fertility medication used to trigger ovulation. This is a very mild fertility medication and, when combined with an experienced doctor and the right dose, will probably be the solution – assuming there aren’t any other infertility factors at work.
If you don’t get pregnant from within three to six cycles (3 to 6 months) of Clomid, it’s best to schedule an appointment with a fertility specialist to establish whether other infertility factors are being overlooked.
Eating Disorders Affect Pregnancy Health
The most important thing to keep in mind is that eating disorders can affect pregnancy health, as well as the healthy development of your baby. Women with eating disorders are at higher risk for:
- Premature labor
- Babies born at a low weight
- Stillbirth or fetal death
- Requiring a cesarean section (C-section)
- Delayed fetal growth
- Gestational diabetes
- Heart and/or respiratory problems
For this reason, your physical and emotional health is even more of a priority than that of an average prenatal patient. Your doctor will work closely with you to address your current diet, lifestyle and state of well-being to minimize these risks as much as possible.
Pregnancy May Trigger Body Image Issues or a Previous Eating Disorder
Also, it’s important to note that getting pregnant can re-trigger latent tendencies towards restricting or controlling your diet. Women who’ve lived for years without starving (anorexia) or binging/binging-purging cravings (bulimia), or women who compulsively exercise, may find the weight gain and body changes associated with a pregnancy and your developing baby trigger all those historical thoughts and feelings around body image, weight and self-worth. Again, we recommend working with a licensed counselor who specializes in eating disorders in addition to your routine prenatal visits to keep a healthy eye on your inner-well-being as your physician and/or midwife support physical wellness.
If you currently have an eating disorder, or have had an eating disorder in the past, and want to get pregnant, schedule a visit with your OB/GYN to have a heart-to-heart. She will have specific recommendations to prepare your body for the upcoming pregnancy and how to gently and compassionately move forward once you’ve conceived so you and your baby can maintain healthy weights and development.