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If you and your partner are trying to become pregnant, it can be utterly crushing to find out that you can’t conceive. You probably feel grief or anger over your situation.

Overall, it’s just not a happy situation for anyone to be in. But you are not alone. About a tenth of the population struggles with infertility.

And anorexia is the mental illness, or cognitive disorder, with the highest mortality rate.

But if you or a loved one suffers from anorexia, and you’re unable to become pregnant, there are options and methods to consider.

This guide aims to assist you or a loved one in understanding the relationship between anorexia and infertility.

Understanding anorexia

Anorexia nervosa is an eating disorder in which the person ceases eating and loses excessive weight -15% less than the average body weight of their body type.

Malnutrition is a common occurrence as is a ceasing of the menstruation cycle if the patient is a woman.

While anorexia literally translates to “loss of appetite”, people who are anorexic aren’t eating because they’re not hungry – they’re not eating because they’re terrified of becoming fat.

This constitutes an illness as it is a disordered way of thinking, and makes the individual believe they are overweight or obese when in fact their body weight is so low that it’s unhealthy.

Anorexia tends to affect females more than males and dancers, actors, and models have a greater risk of developing anorexia or another eating disorder.

What is infertility?

Infertility is an inability to conceive a child. Generally, a couple is deemed infertile if they have been trying and failing to become pregnant for a year.

Both women and men can be deemed infertile since several factors affect whether a woman becomes pregnant such as:

  • The quality of the embryo
  • Sperm’s ability to properly fertilise an egg
  • Healthy sperm production
  • Healthy egg production
  • Whether an embryo can implant into a woman’s uterus

While infertility is commonly considered solely a problem on the women’s end, only about 1/3 of infertility cases are because of the woman’s inability to become pregnant.

1/3 of infertility cases involve men, and the last 1/3 are made up of either a combination of both the man and woman being unable to conceive or a cause that can’t be pinpointed by the doctor.

How does anorexia affect infertility?

  1. Hormones related to body fat: While fat is often considered to be a bad thing, your body actually does need a certain amount to remain functioning. When someone has anorexia or a similar eating disorder, they will most likely have dangerously low levels of fat. Fat cells actually play a role in the production of estrogen and testosterone. If someone has too little estrogen, the reproductive system doesn’t function properly. Lower than average levels of testosterone lead to decreased sperm production and problems with erectile dysfunction
  2. Hormones related to nutrition: But hormone production doesn’t just rely on the levels of fat in your body. Even someone with bulimia who can have either average or above-average weight can experience a period that is either irregular or completely absent altogether. While the connection between nutrition and someone’s ability to conceive is still a little blurry, research has shown how a person’s diet and fertility are connected. If someone is starving themselves, or forcing themselves to expel their food before their body has a chance to absorb the nutrients, they are most likely going to become malnourished. Malnutrition can cause your sperm or eggs to be of poorer quality and your body is going to struggle to create the proper hormones necessary for reproduction
  3. Ovulation and menstruation: It is very common for a woman with anorexia to experience a loss in her period altogether or to have irregular periods. A lost or irregular period often signifies that a woman is not ovulating regularly, either which makes getting pregnant a lot harder. If someone engages in excessive, strenuous exercise or consumes little to no food, she has a higher chance of developing period irregularities. While the frequency of someone’s period does not necessarily determine reproductive ability – someone with irregular periods can still conceive and someone can be infertile even if her periods are regular – it can be a good indicator of fertility problems if your periods aren’t as regular as they used to be
  4. How anorexia shrinks your ovaries and uterus: Pelvic ultrasounds of anorexic women have found that some experience a shrinkage of the ovaries back to their pre-pubescent size. This was especially common in women whose periods had halted completely. The most likely cause of this shrinkage is an imbalance of hormones related to reproduction. Some anorexic women have also experienced a shrinkage of their uterus as well. These shrinkages make conceiving especially difficult

What is Amenorrhea and ‘famine mode’?

In short, Amenorrhea is a fancy way of saying a woman’s period has stopped completely. This generally happens in women who suffer from anorexia, especially if they engage in a lot of strenuous exercises or if she restricts her food intake to a dangerously low level.

Starvation or famine mode is when your body slows down its metabolism as a response to a decrease in the daily calories consumed-especially if the decrease causes daily caloric intake to drop below the required daily calories for the body to function properly.

People in famine mode usually do continue to lose weight, especially if they’re consuming little to no food, but will generally begin to lose weight at a slower rate than they were previously.

Anorexia: the statistics

While the exact number of people suffering from anorexia is unknown, there are an estimated 4 million people who are anorexic that haven’t sought treatment.

Here are a few facts and figures to illustrate how prevalent and damaging anorexia really is:

  • Anorexia more commonly affects women and girls, but over the years, boys and men have also begun to develop anorexia at a growing rate
  • Someone with anorexia usually first develops symptoms around the age of 16-17
  • In 2007, about 6.4% of adults were diagnosed with an eating disorder
  • Of the people who show signs of an eating disorder, about 25% are men
  • The average length someone suffers from anorexia is about 6 years
  • Anorexia is the cause of the highest number of deaths among teens who suffer from a psychiatric disorder
  • Part of this higher rate is the fact that suicide rates among people with anorexia are rising
  • Only about 20% of people with anorexia fully recover from the disorder

Complications during pregnancy

If you manage to become pregnant while you’re anorexic, your pregnancy will most likely be at a much higher risk of running into complications.

Not only is the baby at risk, but the mother is as well.

  • Restricting your calorie consumption
  • Binge-eating or purging after a meal
  • Exercising excessively
  • Abusing laxatives

A pregnant woman who suffers from anorexia will most likely deal with health problems such as depression, malnutrition, heart problems, and premature labour.

The risks to the baby include problems breathing and eating, and low birth weight, and even a stillbirth can occur.

Anorexia during the postnatal period

Because pregnancy causes significant weight gain, some women with anorexia begin to relapse into stricter dieting habits while some women seemed to overcome their anorexia.

There have been few studies done on the evolution of anorexia in post-partum women since few women are able to become pregnant. Because of this, there is little consensus over whether giving birth makes the anorexic feelings worse, or lessen them.

Reproduction recommendations

If you want to have a child, here are a few recommendations to make sure you and your child are both healthy during and after the pregnancy:

  • Make sure you are at a healthy weight before you conceive and avoid purging
  • Seek counselling to assist in uncovering the underlying causes of your eating disorder and continue it through and after your pregnancy
  • Consult a nutritionist to come up with a healthy pregnancy diet
  • Tell your doctor early into your pregnancy that you have an eating disorder
  • Inform your spouse, friends, and doctor if you begin to feel any post-partum depression

It’s important to maintain healthy body weight and attend counselling to help work out the causes of your eating disorder.

If you become pregnant, and you’re malnourished or under your ideal weight, that poses a serious risk to both you and the child you’re expecting.

Coping during pregnancy with an eating disorder

If you become pregnant while you’re struggling with an eating disorder, the most important thing you should do is inform your prenatal health provider.

Try to find someone who is sympathetic to what you’re going through as they will best help you work out your feelings and give you sound advice to keep both yourself and your baby healthy.

You may also need to consider making extra appointments with your prenatal health provider to better track the growth and development of your baby.

Most importantly, you need to allow your health provider to weigh you. This information is essential to tracking the health of you and your baby.

Unplanned pregnancies among women with eating disorders

Because a woman’s period may become infrequent or stop completely, she may come to believe that she is unable to conceive a child.

While it is definitely a little more difficult to become pregnant, women with eating disorders should still take adequate measures to take birth control and practise safe sex to prevent any unplanned pregnancies.

Women with eating disorders also have complicated feelings associated with childbirth and pregnancy. As such, they will often need extra support before, during, and after pregnancy.


Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.