Eating disorders such as anorexia nervosa and bulimia nervosa are known to cause variations in a women’s menstrual cycle. This is thought to be due to the hormonal changes that occur as a result of the eating disorders. These eating disorders can result in anovulation and amenorrhea. These conditions can result in decreased fertility and difficulty with conception. Researchers lead by Dr. Abigail Easter have provided evidence that eating disorders influence the fertility of women and their attitudes toward pregnancy. The results of their study were published online in BJOG: An International Journal of Obstetrics and Gynaecology. The researchers used a longitudinal prospective cohort of 14,663 women who were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The women were classified into four groups and these were lifetime anorexia nervosa, lifetime bulimia nervosa, lifetime anorexia nervosa and bulimia nervosa, and the general population. The researchers evaluated the women for fertility problems, conception time, and attitudes toward pregnancy. The researchers found that women with anorexia nervosa and women with anorexia nervosa and bulimia nervosa were more likely to have fertility problems, and have seen a doctor for fertility problems. Women with anorexia nervosa and bulimia nervosa were found to be more likely to take longer than 6 months to conceive and to have used fertility treatments to aide in conception. The researchers found that unplanned pregnancies were more common in women with anorexia nervosa. In all the eating disorder groups, there was a higher likelihood of having negative feelings regarding the pregnancy compared to the general population. The authors wrote, “[Eating disorder] specialists are ideally placed to approach issues of fertility and family planning with their patients early on during treatment. To overcome any mistaken beliefs about fertility, clinicians should inform women with [eating disorders] that they can still be fertile, even when experiencing disturbed menstrual patterns. In addition, given that many women with [eating disorders] fail to discuss their illness with midwives and obstetricians, multidisciplinary working and the formation of close links with obstetric and gynaecological services should be encouraged when working with a patient who is pregnant”. Women with eating disorders should seek treatment as this has been shown to improve fertility and the chances of conception.
Abigail Easter et al. “Fertility and prenatal attitudes towards pregnancy in women with eating disorders: results from the Avon Longitudinal Study of Parents and Children” BJOG: An International Journal of Obstetrics and Gynaecology published online August 3, 2011 DOI: 10.1111/j.1471-0528.2011.03077.x