By Kristi Eaton
Tuesday, February 1, 2011
When women suffering anorexia stop having their menstrual periods many think they no longer have to worry about birth control. But the recent discovery of a higher rate of unplanned pregnancies among women with the disorder turns that thinking on its head.
(WOMENSENEWS)–As a child with anorexia, I was too young to worry about losing my period.
But many of the older girls and women in my treatment center believed the loss of a regular period was a perk to the potentially deadly illness. With the loss of the menstrual period, called amenorrhea, there was less hassle to deal with each month and less worry about getting pregnant. Many of the women, in fact, believed they could not have children even if they tried, thinking the anorexia had made them infertile.
A study late last year from a leading eating disorders researcher shows the repercussions of such misperceptions for women with anorexia.
Published in the November 2010 issue of Obstetrics and Gynecology, the study indicated that women with anorexia are more likely to have unplanned pregnancies and induced abortions compared to women who don’t have the disorder.
Many women falsely assume that if they are not menstruating or if they are menstruating irregularly that they are unable to conceive, said Cynthia M. Bulik, the study’s lead author and director of the University of North Carolina at Chapel Hill’s Eating Disorders Program.
“There are also a lot of myths out there that people with anorexia nervosa are infertile. This is not the case,” she said. “Of course anorexia nervosa does lead to infertility in some cases, but many women continue to ovulate even in the absence of menstruation.”
Characterized by extreme weight loss because of excessive dieting or exercise, a distorted body image and an intense fear of gaining weight, anorexia affects as many as 10 million women and 1 million men in the United States, according to the Seattle-based National Eating Disorders Association.
High Premature Fatality Rate
Anorexia has the highest premature fatality rate of any mental illness. Some studies indicate that people with the disorder are up to 10 times more likely to die prematurely than those without the disorder. The illness is also on the rise among children.
For the study, Bulik and her team looked at data gathered from 62,060 women as part of the Norwegian Mother and Child Cohort Study. Of the women surveyed, 62 reported having anorexia nervosa.
The researchers found vast differences between the two groups. Those with anorexia were, on average, 26.2 when they delivered for the first time, compared to an average age of 29.9 in the group without the eating disorder.
Of the women with anorexia, 50 percent reported having an unplanned pregnancy, while only about 19 percent of those without the disorder did. Furthermore, almost a quarter of those with anorexia reported having induced abortions in the past. Less than 15 percent of women without the disease reported the same thing.
Kate, a 27-year-old New Yorker who developed anorexia while in college, has had amenorrhea for about three years. She said she doesn’t mind having the menstrual disorder.
“But my doctor put me on estrogen pills to give myself a period because my levels are so low. I just started taking them, so we will see,” said Kate, who asked that her last name not be used because she is in the fitness industry and must maintain a positive image.
Self-Esteem a Factor
Kate said she thinks anorexic women may have a higher percentage of unwanted pregnancies because of the lack of self-esteem that is common among women with the eating disorder.
“As an anorexic, you could put yourself out there more and get pregnant without planning, as self-respect is often low in women with the disease,” she said.
Harry Brandt, director of The Center for Eating Disorders at Sheppard Pratt in Baltimore, said a number of pregnant women suffering from anorexia are on the unit. He hasn’t surveyed patients on their attitudes about birth control, but said, “It wouldn’t surprise me if people who don’t menstruate think they won’t get pregnant; both anorexics and the general population.”
These women may think they don’t need birth control when they actually can become pregnant, he said. Brandt added that a pregnancy for an anorexic woman could be dangerous for both her and the fetus.
“There are problems when an individual with low weight and anorexia does get pregnant because if they continue a pattern of poor nutrition and restrict their intake, they are not eating to support their own bodily function and the developing fetus,” he said.
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Kristi Eaton is a freelance journalist based in Tulsa, Okla., whose work has appeared in the Las Vegas Review-Journal, the Arizona Republic, Ms. Magazine and others. You can visit her Web site at kristieaton.com or follow her on Twitter at twitter.com/kristieaton.