Eating Disorders and Menstrual Health: What Your Cycle Is Trying to Tell You

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Written By Comma

Your menstrual cycle is not just a monthly event, it’s an important vital sign of your overall health.

At Comma, we are taking time this National Eating Disorder Awareness Week to bring awareness to an often overlooked symptom of numerous eating disorders: changes in the menstrual cycle. Food is nourishment for the mind and body. It fuels your everyday activities, supports brain function, strengthens your immune system, and provides the energy needed for the body to perform complex and extraordinary processes—including reproduction, for those who choose that path.

Many people don’t realize that restricting food intake and over-exercising can disrupt hormonal balance, leading to irregular cycles, missed periods, and, in some cases, fertility challenges such as difficulty conceiving. This is especially true in the context of eating disorders and disordered eating, which can exist even when they are not outwardly visible.

Disordered eating can include:

  • Chronic dieting

  • Skipping meals

  • Fear-based food rules

  • Compensatory or excessive exercise

  • Obsessive tracking or restriction framed as “wellness”

When Food Intake Affects the Cycle

Menstruation depends on a delicate balance of hormones that require adequate energy, nutrients, and body fat to function properly. When the body recognizes that it is not receiving enough energy—whether through restriction, purging, excessive exercise, or chronic under-eating—it shifts into conservation mode.

One of the first systems affected is often the reproductive system.

That can look like:

  • Irregular periods

  • Very light bleeding

  • Missed periods (amenorrhea)

  • Complete loss of menstruation for months or years

In other words, the body prioritizes survival over reproduction. When energy is limited, ovulation is suppressed, estrogen drops, and the menstrual cycle slows or stops altogether.

Listening to your cycle is an important part of protecting long-term health and wellbeing.

Amenorrhea is a Signal, Not a Symptom to Ignore

Amenorrhea is the absence of menstruation. Clinically, it is defined in two ways: primary amenorrhea, when someone has not had their first period by age 15, and secondary amenorrhea, which is the loss of a menstrual period for three or more consecutive months in someone who previously menstruated regularly. Today, we’re focusing on secondary amenorrhea—particularly when it is linked to energy deficiency, stress, or disordered eating.

For years, missed periods—especially in athletes or people with lower body weight—have been normalized or even praised. But amenorrhea is not benign. It is a sign that the body is under strain.

When menstrual cycles stop, estrogen levels often fall. Over time, low estrogen can contribute to:

  • Bone density loss and increased fracture risk

  • Cardiovascular strain

  • Hormonal dysregulation

  • Fertility challenges, including difficulty conceiving or increased miscarriage risk

  • Increased psychological and emotional stress

Clinically, this pattern is often referred to as functional hypothalamic amenorrhea—a condition in which the brain suppresses reproductive hormones in response to energy deficiency, restrictive or disordered eating, excessive exercise, or chronic stress.

Importantly, amenorrhea can occur at any body size. Eating disorders and disordered eating are not defined by weight, and neither are their health impacts.

The Mental and Emotional Toll

Eating disorders are not just about food. They are deeply intertwined with control, stress, trauma, perfectionism, and societal pressure. Many people experiencing an eating disorder become consumed by thoughts about food, weight, and control—often at great mental and emotional cost.

When menstrual changes are dismissed as “normal,” “stress-related,” or “just hormones,” people are often left without answers and may not feel taken seriously.

Listening to the menstrual cycle means listening to the full context of someone’s life—their stress, their nourishment, their relationship with their body, and their sense of safety.

When to Seek Support

Menstrual changes can happen occasionally due to illness or acute stress. But it may be time to seek support if:

  • Your period has been absent for three or more months

  • Food, exercise, or body image concerns begin to dominate your thoughts or daily decisions

  • You’re experiencing fatigue, dizziness, hair loss, or stress fractures

Reaching out doesn’t mean something is wrong. It means you’re listening.

Recovery is Possible

If this resonates with you, you are not alone. We see you, and we hear you. You are not defined by your weight, your appearance, or your food choices.

An eating disorder diagnosis does not determine your future—and it does not automatically determine your fertility. Research shows that after recovering, women have similar fertility rates to those who have never experienced an eating disorder.

Recovery is possible. Menstrual health can return. And support is available.

Resources

Seeking help is a sign of strength, not weakness. If you or someone you love is experiencing signs of an eating disorder, these trusted resources are here to help.

Sources:

Acute Center for Eating Disorders & Severe Malnutrition: Amenorrhea & Menstrual Abnormalities in Eating Disorder Patients

National Alliance for Eating Disorders: Can Eating Disorders Affect Fertility?

Harvard Health Publishing: Amenorrhea

National Library of Medicine*: Functional Hypothalamic Amenorrhea: Recognition and Management of a Challenging Diagnosis*

UCHealth: Amenorrhea

Comma
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Hysterectomy, Hysteria, and the “Wandering Uterus”