Amenorrhea & pregnancy: not mutually exclusive

Although I think that the relationship between eating disorders and infertility is pretty well-established, what makes this article (Eating disorders delay pregnancy) interesting is the contrast between planned and unplanned pregnancies:

Study findings:

  • Pregnancy rates after 6 months of trying to get pregnancy were lower in women with anoreixa or bulimia
  • Women with EDs were more likely to need fertility treatment
  • The rate of unplanned pregnancies was HIGHER in those with a history of anorexia

While it took me a few minutes to rationalize how unplanned pregnancies could be MORE common in those with an ED history, I did eventually come up with a few theories:

  1. Amenorrhea is deceptive – while lots of people think that you CAN’T get pregnant if you’re not getting your period, it’s just not true.  It happens.  I’d guess this is the largest contributing factor to the higher rate (the article says “underestimating their chances of conceiving,” but they’re probably one in the same).
  2. Periods are undesirable — meaning, when you don’t have a period, opting to go on birth control and get one seems… ludicrous?  I know people feel very differently on this subject, but I’m just saying, amenorrhea can be kind of convenient.
  3. Sexual abuse history — many women with EDs have some kind of trauma history, and there is a lot of research out there suggesting that women who suffered sexual abuse have an increased risk of early and/or unplanned pregnancy.
  4. Invincibility — you know how you’re told all those risks of having an ED, like heart attack, osteoporosis, esophageal tear (not to mention DEATH), and you think “yeah, whatever?”  I think that could definitely apply to the “it’s not going to happen to me” mentality of unplanned pregnancy.
  5. Self-care deficit – maybe it’s not “it won’t happen to me,” so much as “I don’t care.”  When you don’t have a lot of respect for your body (or, you WANT to hurt yourself), there isn’t a lot of motivation TO use protection.
  6. Birth control effectiveness — some antidepressants reduce the effectiveness of birth control, and I’d venture to say that more than half of people with EDs are on some kind of medication for a mood disorder.  Also… while I’m probably grasping at straws here, I’d also bet that purging is not great for effectiveness when on the pill, either.

If there’s one thing that you take away from this post, I hope it’s this: You can get pregnant even if you don’t get your period.  Really. 

One thought on “Amenorrhea & pregnancy: not mutually exclusive

  1. Emily

    I know you said that you are grasping as straws with number 6, but I think that purging messes with all sorts of medication, not just birth control. If anything, I thing the birth control might be extra problematic since I have read that taking the medication at the same time each day is especially important in the lower does pills that are currently on the market.

    I had an anorexic friend who accidently got pregnant while she was in college, so I know first hand that it can actually happen…

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