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How bulimia affects your period

Eating disorders like anorexia nervosa (AN), binge eating disorder (BED), and bulimia nervosa (BN) may cause all manner of menstrual disturbance.

Bulimia nervosa, in particular, has been known to shorten cycles, stop menstruation all together for a short period of time, cause cycles to occur at irregular intervals, give you more periods than normal, or cause a light flow during the cycle.

That's because BN often impacts the body in ways that cause hormonal disruptions, which can, in turn, lead to a disrupted menstrual cycle, or period.1

Last updated on 
June 6, 2023
June 6, 2023
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How does bulimia affect your periods?

Eating disorders like bulimia nervosa may be mental health disorders, but they can have an outsized impact on physical health.

Any condition that affects your nutritional intake has the potential to affect your menstrual period. So when asking yourself, “can bulimia cause irregular periods,” there are a few things to consider.

Hormonal imbalances

Hormonal imbalances are the chief factor behind menstrual dysfunction. And the production of hormones—or disturbance thereof—is heavily impacted by eating behaviors.

One study found that all participating patients with bulimia nervosa had pathologically low levels of follicle-stimulating hormone (FSH), a hormone responsible for many aspects of sexual development and reproduction. Levels of luteinizing hormone (LH), the chemical responsible for spurring ovulation and producing many of the hormones needed to support pregnancy, were also significantly low.2

In the study, about one third of those with bulimia nervosa also had polycystic ovarian syndrome (PCOS), which is known to affect periods.2

Body weight

Bulimia nervosa, like many other eating disorders, often impacts body weight.

When body weight regularly fluctuates, as sometimes happens when people engage in purging and binge eating behavior, the changes can put pressure on the body's metabolic processes.1

Help for bulimia and binge eating disorder is within reach. Learn about virtual treatment options and how to get help.

These processes impact how the body absorbs and uses the nutrients it receives, and disruptions can lead to a disturbance in hormone production and other factors that may lead to irregular menstrual periods.1

When body weight regularly fluctuates, as sometimes happens when people engage in purging and binge eating behavior, the changes can put pressure on the body's metabolic processes.1 These processes impact how the body absorbs and uses the nutrients it receives, and disruptions can lead to a disturbance in hormone production and other factors that may lead to irregular menstrual periods.1

Low body weight is another common outcome of bulimia nervosa. This can also impact menstrual cycles, mostly through causing amenorrhea, or the loss of the period. Again, the connection between low body weight and irregular menstruation is primarily through the changes weight loss can have on hormonal production.4

Malnutrition

Malnutrition can potentially affect an individual's period, regardless of their weight.1

In general, certain vitamins, minerals, and nutrients play an important role in hormone production, and changes in these levels can result in menstrual disturbances and infertility.

Poor nutrition has also been connected to changes in the hypothalamus, essentially the brain's control center, which sends signals throughout the body to start and stop any number of internal processes. Lack of certain nutrients, vitamins, or minerals can cause this area of the brain to go into "survival mode," shutting down processes, such as menstruation, that are considered non-essential for short-term preservation.5

Bulimia and pregnancy

Aside from causing menstrual irregularities and other issues with menstrual function, bulimia nervosa can also impact pregnancy, or someone's ability to become pregnant.

Similar impacts the condition has on the body's hormonal system that cause irregular menstrual cycles can also prevent the body from ovulating, or releasing eggs, on a regular basis, making it difficult to get pregnant.6

Unfortunately, BN can also lead to problems during pregnancy, including a heightened risk for miscarriage, premature birth, and low birth weight. Some studies have also connected the condition to a higher chance of experiencing postpartum depression.6

How to help correct periods affected by bulimia

Menstrual irregularity caused by bulimia nervosa or other eating disorders can be addressed through several methods, primarily involving techniques to help regulate hormone production.

Hormone treatments
Eating to support hormone production

Finding treatment for bulimia nervosa

Losing your period, having an unreliable period, or experiencing difficulty getting pregnant can be profoundly upsetting experiences. But, with the right kind of treatment, these conditions can be reversed.

When looking for help with period regulation, it's essential to treat underlying causes, such as bulimia nervosa. Treatment for BN should be multidisciplinary, addressing the many emotional, physical, and psychological factors that drive or maintain the condition.

Treatment for BN should be multidisciplinary, addressing the many emotional, physical, and psychological factors that drive or maintain the condition.

In cases where your menstrual cycle is effecting, consulting with a dietitian can be especially helpful, to establish a meal plan which may contain supplements that are appropriate for your body and the symptoms you're going through.

And, as with all manner of healing, patience is key. It can take months after starting treatment for your period to return, or to come back on a regular cycle. But with a commitment to treatment and healing, it's possible to see your body return to its natural functions and capabilities, and keep on moving toward a healthier future.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Gendall, K. A., Bulik, C. M., Joyce, P. R., McIntosh, V. V., & Carter, F. A. (2000). Menstrual cycle irregularity in bulimia nervosa. Journal of Psychosomatic Research, 49(6), 409–415.
  2. Resch, M., Szendei, G., Haasz, P. (2004). Bulimia from a gynecological view: hormonal changes. Journal of Obstetrics and Gynaecology, 24(8), 907-10.
  3. Zava, D. T., Dollbaum, C. M., and Blen, M. (1998). Estrogen and progestin bioactivity of foods, herbs, and spices. Proceedings of the Society for Experimental Biology and Medicine, 217(3), 369-78.
  4. Amenorrhea. Mayo Clinic. Accessed May 2023.
  5. Hypothalamic Amenorrhea. Cleveland Clinic. Accessed May 2023. 
  6. Bulimia Nervosa. Office of Women’s Health. Accessed May 2023. 
  7. Managing Menstruation with Hormonal Contraceptives. (2019). Children’s Hospital of Philadelphia. Accessed May 2023.
  8. What are the common treatments for menstrual irregularities? National Institutes of Health. Accessed May 2023.

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