Funky Forest Health & Wellbeing
  • Home
  • About
    • About Casey
    • Philosophy >
      • Non-Diet Approach
      • Health At Every Size HAES ®
      • Intuitive Eating
      • Holistic Dietitians
    • Modalities >
      • Dietitian
      • Naturopath
      • Nutritionist
    • Treatments >
      • Dietetic & Nutritional Therapy
      • Eating Disorder Therapy
      • Herbal Medicine
      • Flower Essences
  • Services
    • Consultations >
      • How I Can Help
      • Fees & Rebates
      • Book a Consult
    • Community Clinic
    • Yoga >
      • Class Schedule
      • Private Sessions
      • AcroYoga
    • Herb Walks
    • Freebies >
      • Newsletter
      • A Modern Yogi's BS-Free Guide to Wellbeing
      • Elimination Diet Email Series
  • Apothecary
  • Podcast
  • Blog
  • Contact
    • Newsletter

Casey's blog

periods, fertility & eating disorders

21/5/2019

 
Picture
"I have my period. So I mustn't have an eating disorder."

For years I thought that if a woman was menstruating regularly, she was displaying one of the ultimate signs of health.

​I thought that if a woman had a regular period she must be well nourished. That the moment her caloric intake dipped below her requirements, her body would stop ovulating and periods would disappear.
​
That Mother Nature never lets our bodies grow babies -  a highly energy intensive endeavour that demands massive amounts of resources - in a perceived famine.

For years, I was wrong.

​In my time as an eating disorder dietitian, student naturopath, and having lived through an (undiagnosed but still very harmful) eating disorder, I have learnt a thing or two about periods and under eating. Here I'll attempt to bust some common myths around periods, fertility and disordered eating.

Myth #1: Anorexic women can't fall pregnant

To give myself some credit, it is generally accepted in the eating disorder community that the more severe or prolonged a woman's eating disorder is, the more significant the medical, gynaecological, and obstetrical complications (1). 

In other words, eating disorders and disordered eating increase the chance that you won't ovulate normally, and therefore your period will be scanty, irregular, or absent.

There is plenty of research showing that many women who have an active eating disorder or disordered eating (whether diagnosed or not) struggle to get pregnant due to ongoing nutritional and psychological stressors that impair their ovulation and fertility*.

BUT... there are also plenty of women who, despite being in a significant calorie deficit, still have their periods and still fall pregnant.

Having a period is NOT a reliable indicator of optimal health and nutrition status.

Some of us have a genetic makeup that is incredibly sensitive to our environment: the moment a prolonged drop in caloric intake is detected, the hormones that keep our reproductive functions afloat will shut down and periods will stop.

Others, however, will continue to menstruate after months or even years of restrictive eating. For these women, their genetic blueprint dictates that despite significant malnutrition their reproductive function continues, although other body systems (such as brain function, immune status or digestion) may suffer.

By the way, all of this can happen regardless of what a woman weighs. People can be anywhere on the BMI scale and still be malnourished. Women (including folks suffering from anorexia nervosa) can be of ANY body size and still lose their periods due to malnutrition. That only visibly emaciated folks are malnourished is a myth.

So to bust this myth, underfed women of all body sizes CAN still have a period, ovulate, and fall pregnant. They can also lose their periods altogether, or sporadically.

*Eating disorders also increase the risk of problems with pregnancy and birth, including miscarriage, developmental abnormalities, preterm delivery, and lower birth weight leading to more difficult, intervention-heavy births. But for this article I'm going to focus on periods and ovulation in relation to eating disorders, rather than pregnancy and birth.

Myth #2: Having a period means you musn't have an eating disorder

​Lack of menstruation (or amenorrhoea) is one possible symptom of an eating disorder, but it doesn't work the other way around: having a period does not rule out the presence of an eating disorder. 

​That was important so I'll say it again: Having a period does not prove that you are well. If you or others close to you are concerned you have issues with your eating, the presence of a period does not give you the all clear to brush these concerns aside. Doing so can prolong your time to getting treatment. Unchecked, disordered eating patterns can wreak havoc on your physical and mental health.

You can have an active eating disorder or disordered eating and still have a regular period. You can also be years into recovery and not be getting your period. This is due to something called individual variability.

(By the way, many other things can cause amenorrhoea that have nothing to do with disordered eating, including PCOS, pregnancy, lactation, thyroid and other hormonal abnormalities. These are topics for another day).
​​

Individual variability is a thing

Yes, you can be getting your period (and fall pregnant) even if you're undernourished. You can also not have your period long after resuming normal eating and being at a weight your body naturally wants to be at. Check out these real life cases of some female clients I have known and/or worked with:

1. Bethany* age 28, with a long history of severe anorexia nervosa and no period in six years, assumes she is infertile. She falls pregnant after having unprotected sex.

2. Mian* age 31, is mother to a toddler. She has an undiagnosed restrictive eating disorder. Despite numerous signs of malnutrition she is still lactating. A year after her child is born her period returns. Mian wishes to fall pregnant again as quickly as possible. Despite advice from her GP to first address her restrictive eating and restore her weight, Mian starts having unprotected sex in the hope she will fall pregnant.

3. Camille* age 35, wants to start a family. She lost her menstrual cycle five years ago after battling through several cycles of restrictive eating and bulimia. Despite being fully recovered, nutritionally rehabilitated and at a healthy weight for the last two years, she still has no period.

4. Faiza* age 22, is a chronic restrictive dieter and has not had a period for the past year. She went to see a naturopath who prescribed herbs that made her period come back. She continues to eat very little, over-exercise and worry about her weight.

​

Mo' menses, mo' problems?

This is a kinda serious and heavy topic so to break the tension, I made a little pun above (you kids who grew up in the 90's will get where I'm coming from). Any excuse for a music video hey?
Ok, back to the topic at hand.
It's misguided to think that if you have a period, you can't possibly have an eating disorder. If you have a period despite your eating being somewhat restrained or restricted, don't be lulled into a false sense of security that all is well. You may fall into the camp where, due to genetic tendencies your body menstruates even when it is very malnourished. ​

If this is you, I implore you to get the help you need to heal your disordered eating.


Even if you're still having a menstrual period (i.e. you bleed), you may not be ovulating (more about that soon). And if you're not ovulating, you face the same hormonally-based health risks as women who don't get periods at all. The ramifications of not ovulating (and the attendant lack of monthly oestrogen peaks) become evident as we age in the form of osteoporosis and increased risk of bone fractures, depression and cardiovascular problems.

Conversely, if you are NOT menstruating and you suspect you have some form of disordered eating or an eating disorder, please seek help. It is possible to restore your fertility. Even if you never want to have children, regular ovulation has many health benefits including protecting your long term cardiovascular, brain and bone health. 
​

Myth #3: You can take herbs or meds to bring your period back (and forget the food part)

Doctors may prescribe oestrogen medications to increase levels and bring on a period. Naturopaths may prescribe herbs such as Chaste tree (Vitex agnus-castus) in women with hypothalamic amenorrhoea, a condition which often arises when women under eat.

These treatments can be of immense help for some women; I have personally experienced their value as temporary solutions. For years I had disordered eating behaviours (which at a certain point morphed into an undiagnosed eating disorder). My restrictive eating and exercise obsession lead to the cessation of my periods (in the form of hypothalamic amenorrhoea) for nearly a year. I then saw a naturopath who prescribed herbs and after a short time on herbal treatment my period returned.

The problem with these treatments is that the return of a period can lead some women into complacency regarding their disordered eating. It may discourage them from seeking help to treat the underlying disordered eating behaviours which caused their periods to stop in the first place. I have seen this in many women, and I have experienced it first hand.

From my personal experience with disordered eating and using herbs, I continued to somewhat restrict my food and over-exercise after the herbs "made" my period come back. It was only years later that I discovered intuitive eating, began to nourish myself properly and finally achieved hormonal restoration without needing to rely on herbs to have a normal menstrual cycle.

By the way, this is why I strongly believe that natural health practitioners should be trained in the recognition and management of eating disorders, which I discuss at length here.
​

Myth #4: Having a period means you're ovulating

It's important to understand that it is possible to have a period yet not be ovulating (and therefore not be able to conceive). This is called an anovulatory cycle and it happens when none of your follicles reach full maturity.

​You do not ovulate, so you do not form a corpus luteum, and you do not make progesterone. But you still bleed because your growing follicles still make oestrogen, which is the hormone that thickens your uterine lining - and at some point that lining has got to be shed (2). 

When a woman is under eating, her cycles may become anovulatory even if she still has a menstrual period (bleed).

You can also get anovulatory bleeds with certain conditions including PCOS, perimenopause, or if you have an implant or injection methods of hormonal birth control (but NOT the pill - in which case you have no cycle at all, and the bleed is not a true period but a drug withdrawal bleed) (2).

There are ways to check to see if you are ovulating including tracking your temperature (as in the Fertility Awareness Method) and/or tracking changes in your cervical mucus. 

In summary

Women of all sizes who under eat can lose their periods, or keep them. They may ovulate or not ovulate. They may be able to conceive or they may not. Regardless of your period status, if you have issues with food, body or eating, please be gentle with yourself and seek the professional help you need. You deserve to get better.

​*names have been changed.
​

References

(1) Gaudiani, JL (2019). Sick enough: a guide to the medical complications of eating disorders. Routledge, New York.

(2) Briden, L (2017). Period repair manual: natural treatment for better hormones and better periods. Second edition. Lightning Source, UK.

Comments are closed.

    Categories


    Picture
    Picture
    Picture
    Picture
    Picture
    Picture

    POPULAR POSTS


    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture
    Picture

    ARCHIVES


    April 2025
    November 2024
    October 2024
    March 2024
    November 2023
    June 2023
    May 2023
    April 2023
    March 2023
    February 2023
    January 2023
    October 2022
    September 2022
    July 2022
    May 2022
    April 2022
    March 2022
    December 2021
    November 2021
    July 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    July 2019
    June 2019
    May 2019
    March 2019
    February 2019
    January 2019
    December 2018
    October 2018
    September 2018
    July 2018
    May 2018
    April 2018
    March 2018
    January 2018
    December 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    October 2016
    September 2016
    August 2016
    June 2016
    April 2016
    March 2016
    January 2016
    October 2015
    September 2015
    July 2015
    June 2015
    May 2015
    March 2015
    January 2015
    December 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    December 2013
    October 2013
    September 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    January 2013
    November 2012
    October 2012
    September 2012
    August 2012
    July 2012
    June 2012
    May 2012
    December 2011
    November 2011

    MORE CATEGORIES


    All
    Allergies
    Autumn
    Ayurveda
    Babies & Children
    Best Of The Blog
    Body Care
    Body Image
    Body Inclusivity
    Body Positive
    Breakfast
    Breastfeeding
    Chocolate
    Consultations
    Cravings
    Desserts
    Detoxification
    Dinners
    Disordered Eating
    Dreaming
    Eating Disorders
    Education
    Environment
    Essential Oils
    Exercise
    Family Nutrition
    Farming
    Feminism
    Fermented Foods
    Fertility
    Fitness
    HAES
    Healing
    Health
    Health At Every Size
    Health On A Budget
    Herbal Medicine
    Herbs
    Homesteading
    Hormones
    Immune Health
    Integrative Medicine
    Intuitive Eating
    Lunch
    Magic
    Meditation
    Menopause
    Menstruation
    Metabolism
    Mindful Eating
    Moon
    Motherhood
    Movement
    My Personal Story
    Natural Cycles
    Naturopathy
    Non Diet Approach
    Non Diet Yogi Podcast
    Non-Diet Yogi Podcast
    Nutrition
    Omnivorous
    Paleo
    Permaculture
    Plant Spirit Communication
    Podcasts
    Postpartum
    Powerlifting
    Prenatal
    Probiotics
    Raw
    Recipes
    Recommended Reading
    Self Love
    Sex
    Simple Eating
    Skin
    Smoothies
    Snacks
    Social Justice
    Spirituality
    Spring
    Strength Training
    Stress
    Summer
    Superfoods
    Supplements
    The Wellness Diet
    Traditional Chinese Medicine
    Traditional Foods
    Traditional Wisdom
    Vegan
    Vegetarian
    Veterinarian
    Weight Neutral
    Wildcrafting
    Winter
    Witch
    Women's Health
    Yoga

    RSS Feed


    Picture
    Picture
    Picture
Picture
All content copyright Casey Conroy - Funky Forest Health & Wellbeing. For more information please click here to see my disclaimer.
Natural health for EVERY body. Copyright © 2024
​
0432 618 279 | [email protected]