Bulimia can also hinder a woman's chances at motherhood. As with women who have anorexia, women with bulimia often lose their periods completely or have erratic ones. Researchers are not sure why. Some hypothesize that purging causes the reproductive tumult. But others point out that women with bulimia often starve between binges, sometimes going for several days without eating. So it is actually the starvation cycle that shuts down a woman's periods. Stress can also play a role in this irregularity. Stress may be physical, as from vomiting, or psychological, as from anxiety about being discovered. The bottom line is that women with bulimia also run into infertility issues.
But, unlike women with anorexia, women with bulimia may lose their periods only some of the time. When they are eating, their monthly cycles may resume, leading to unpredictable cycles. Add to this another characteristic of bulimia: women with the disorder often have overactive sex drives. According to Joanna Poppink, women with bulimia can binge on sex just as voraciously as they binge on double-fudge cookies. This connection also leads to promiscuity among women with the disorder.
The combination of irregular periods, promiscuity, and regular purging may cause a woman to inadvertently vomit her birth control pills: women with bulimia have more unplanned pregnancies than the norm. Herzog's team at Massachusetts General observed that 54 of the 246 women in the study sample became pregnant, some several times, resulting in 82 pregnancies overall. Although the larger study consisted of women who had anorexia, bulimia, or both, only 7 of the women who became pregnant had classic anorexia, in which they starved but did not binge or purge. This makes sense: women with anorexia are not getting pregnant as often as those who have bulimia.
Now look at the psychology. A young woman who has not grown up herself, and has a desperate fear of taking care of another life, becomes pregnant accidentally. What is she likely to do? She is most likely to seek an abortion. In the Massachusetts General study, only half of the 82 pregnancies resulted in live births, as compared to two-thirds in the general population. This was largely due to a higher rate of abortion. The women in the study who were most likely to abort were single. In fact, the disparity between single and married women who had abortions was so striking that researchers framed single parenthood as a risk factor for pregnancy termination.
Strike one is the eating disorder, leaving the woman developmentally immature. Strike two is her fears about motherhood, born out of that immaturity. Strike three is the lack of a partner to help support her in managing the new responsibilities of parenthood. Suja Srikameswaran, who works mainly with pregnant women with eating disorders at St. Paul's Hospital in Vancouver, British Columbia, adds another insight. The typical patients she sees are pregnant women between the ages of 22 and 42, half with anorexia nervosa and half with severe bulimia nervosa, defined by bingeing and purging so frequently as to interfere with daily functioning.
She points out that most of the pregnancies are unplanned. This fits with links between bulimia, irregular periods, and an overzealous sex drive. But in Srikameswaran's group, the majority of women chose to carry their pregnancies to term. The difference might be explained by the fact that most of Srikameswaran's group was married or had steady partners. In fact, their referral to St. Paul's clinic came because they wanted to have their babies. The women were stepping forward voluntarily, asking for help in coping.
The message here is that if a woman with an eating disorder becomes pregnant, she needs support, and lots of it. Every motherto- be has fears when pregnant, especially for the first time. However, women with eating disorders often experience a fear that is paralyzing. It may be that a committed partner can help a woman with an eating disorder overcome her fears during pregnancy. If she lacks a partner, then she needs to draw from other resources, such as friends and family.
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1. Recover from eating disorders by being honest with yourself
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