Eating Disorders and Infertility

As many of us have found as we battle this foe called "infertility, ú so many factors can play a part in whether or not we will be able to conceive. Unfortunately, here is an additional aspect to consider. Eating disorders affect more than 5 million American women in their teens through child-bearing years. Unfortunately, these millions of women may not even know that their fertility, in addition to their health in general, is at risk.

Anorexia Nervosa

Anorexia nervosa is one type of eating disorder. It affects approximately one in 100 women. Anorexic sufferers are those individuals, predominantly women, who deliberately starve themselves because they perceive themselves to be overweight. Patients are diagnosed as anorexic when their weight loss drops them to 85 percent or less of their ideal body weight. These women usually have a distorted body image and a great fear of becoming fat. Victims of anorexia may already be extremely thin but still think that they have weight to lose. Without treatment, death can (and often does) occur. Treatment is available and encompasses both physical and psychological processes.

Anorexia is associated with a variety of health problems, many of which directly effect fertility. It causes damage to major organs like the heart, liver and kidneys. Fainting, constipation, hair loss and anemia are all consequences of anorexia. Fertility-wise, the main concern is amenorrhea (no menses). It can even become a permanent condition, depending on how long a woman suffers from anorexia. Body fat is required to produce the hormones necessary for ovulation to occur. When weight and body fat fall below this level, ovulation will cease, and the woman will not menstruate, and, therefore, be unable to achieve pregnancy.

Bulimia Nervosa

Bulimia nervosa is the another major type of eating disorder. It is more prevalent, affecting 2 to 5 percent of women. The symptom most commonly associated with bulimic women is typically a "binge and purgeú routine. Binging is characterized by consuming large amounts of food (up to 2000 calories!) in one sitting, followed by some sort of purge activity, such as vomiting, laxative use, or over-excessive exercise. Bulimia can be hidden more easily than anorexia because a relatively normal weight can be maintained; however, significant weight fluctuations may also be noticed. Bulimic women are overly concerned about their weight and often have to use the restroom right after eating to purge. Treatment is also available and, like anorexia, is a physical and psychological process.

Bulimia can cause many health complications, some of which can hinder fertility as well. Damage to the teeth and gums are common. Frequent vomiting deteriorates the enamel of the teeth, causes swollen salivary glands and can damage the esophagus. It causes dehydration, organ damage and depletes the body of key minerals like potassium. The body's electrolyte balance is also disturbed, which can inhibit a healthy pregnancy.

The Big Risks

Eating disorders in general are associated with a variety of pregnancy and fertility related problems. They cause hormonal imbalances that can interfere with ovulation and vitamin deficiencies that make it hard to carry a full-term pregnancy or can lead to a baby born with birth defects. Women with eating disorders are also more likely to have a high-risk pregnancy, to develop gestational diabetes, more likely to miscarry and are more prone to still-born babies or morbidity shortly after birth. Babies born to mothers with eating disorders are at increased risk of delayed fetal growth, low birth weight, jaundice, premature delivery, and other complications during labor. General health problems of eating disorder patients, such as damage to teeth and bones or cardiac and kidney damage, can become worsened during pregnancy. Osteoporosis is more prevalent in women who suffered from eating disorders.

There is Hope

The good news is that although eating disorders can have so many detrimental effects on fertility, 75-80 percent of women who successfully treat their disorder and achieve a normal body weight will be able to conceive. There may be other factors affecting your fertility as well though, so overcoming your eating disorder is not a guarantee that you will become pregnant. If you have a history of an eating disorder and want to become pregnant there are some things you can do before and during pregnancy:

Maintain normal body weight before you get pregnant.
Avoid any purging activities.
Since pregnancy can be hard on the mother's body, it is of utmost importance that the mom be as healthy as possible while she is pregnant. Notify your doctor if you have had an eating disorder to ensure you get the best prenatal care.
Eat a healthy diet and stick to your doctor's pregnancy weight-gain guidelines.
Take prenatal vitamins, and ask your doctor whether you need iron or calcium supplement.
If you start to feel uneasy about your body and the weight you gain during pregnancy, or have some lingering body image issues, talk to your doctor or counselor.

Eating disorders affect many women and can have some life-threatening consequences. It can also contribute to the heartbreak of infertility. However, the effects of eating disorders on your infertility can be dealt with if you take care of yourself and seek treatment for your disorder. Anorexia and bulimia can be very hard to confront, but you don't have to face it alone. Help is available through organizations like The Center for Eating Disorders (see their website at www.eatingdisorder.org or call them at 410-427-2100) or the National Association of Anorexia Nervosa and Associated Disorders (www.anad.org or 847-831-3438). The first step is to recognize the problem so that treatment can begin.

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