Why Is My Period Missing?
How Eating Disorders Affect the Female Body
Eating disorders such as anorexia (anorexia nervosa) and bulimia are severe mental illnesses that have far-reaching effects on the female body. They often revolve around the desire to control food intake and weight. However, this control frequently leads to significant health issues—both physical and psychological. Many affected individuals first visit a gynecological practice due to a missing period, unaware that an eating disorder may be the underlying cause.
Effects of Anorexia on the Female Body
Missing Period (Amenorrhea)
Women with anorexia often experience a cessation of their menstrual cycle. This occurs because the body, facing extreme energy deficiency, prioritizes essential survival functions. Reproduction is not a priority in this “emergency situation.”
- The ovaries reduce their function and suspend egg maturation.
- Estrogen and testosterone levels drop.
- In the long term, this can lead to irreversible damage such as osteoporosis, a serious condition that increases the risk of bone fractures.
Growth Disorders in Adolescence
If girls develop anorexia before puberty, their development may be stunted. Important developmental milestones such as breast development, pubic hair growth, or the onset of menstruation may be delayed or absent. According to the international HBSC study, about 14% of 11- to 15-year-old girls in Switzerland have already tried dieting, and 3% of them are underweight—posing a risk for long-term developmental problems.
Fertility and the Desire to Have Children
The absence of menstruation is not only a sign of missing ovulation but can also have long-term effects on fertility. Even after sufficient weight gain and the restoration of a normal body weight, around 30–40% of women continue to experience ovarian insufficiency. In these cases, ovulation does not return, making it difficult to conceive naturally.
- Hormonal stimulation may help trigger ovulation.
- If pregnancy is achieved, affected individuals should be closely monitored, as weight gain during pregnancy can increase psychological stress and the risk of worsening the eating disorder.
Other Health Consequences of Anorexia
Weakness and Fatigue
Due to energy deficiency, affected individuals often feel weak and exhausted. Thyroid function is also suppressed, which may mistakenly resemble hypothyroidism.
Stress Hormone Cortisol
Cortisol, the stress hormone, is often elevated in anorexia. This occurs to maintain blood sugar levels (euglycemia). Because the body, due to energy deficiency, has little access to normal reserves such as carbohydrates, increased cortisol mobilizes other energy sources like proteins and fats to meet vital energy needs. Elevated cortisol levels can persist for years after recovery and usually do not require treatment.
Bone and Blood Health
- Low hormone levels accelerate bone loss and increase the risk of osteoporosis.
- Bone marrow becomes “hypoplastic,” meaning fewer blood cells are produced. This can lead to anemia (low red blood cell count) and weakened immune function, making affected individuals more prone to infections.
Cholesterol Levels
Anorexia can lead to elevated cholesterol levels. However, cholesterol-lowering medications are not recommended, as they could further worsen the body’s energy deficiency. A low-fat diet should not be followed in these cases.
How Can We Help?
Anorexia is a serious illness that severely affects not only mental health but also the entire body. Alongside weight restoration and psychotherapy, early recognition and treatment of physical consequences are crucial to preventing long-term damage such as osteoporosis, ovarian insufficiency, or infertility.
Since many affected individuals first visit a gynecologist due to a missing period, gynecologists play a key role in diagnosis. Hormonal therapies can help improve bone health and support fertility goals. We at gynhealth are always here to support you!
