It is estimated that a whopping 10 million women in the US suffer from eating disorders and one in five fall victim to eating disordered thinking. Eating disorders result from a myriad of different causes and are very difficult to treat. It is common for women to swing back and forth between various disorders, or even engage in more than one type of behavior at once (binge eating, restricting food, compulsive overeating, purging, excessive exercising, etc.).

The most immediate effect of an eating disorder on a woman's sexual health is the interruption or absence of menses, which is typically referred to as amenorrhea. This happens when a woman is at least 15% below the recommended weight for her height and body type. The dramatic reduction of fat stores in the body results in decreased thyroid levels and increased cortisol (stress) hormones. Called hypercortisolism, this particular state leads to a reduction in the reproductive hormones (such as estrogen) that facilitate a monthly cycle. In this way, it can be seen as similar to delayed menses during a very busy time at work or school.

Secondary amenorrhea is not dangerous in its own right, but it is still cause for alarm. Prolonged low levels of estrogen in the body may lead to disruptions in bone growth and osteoporosis. Regular menstrual cycles are usually regained once a woman achieves a healthy weight, but a recent study showed that the ability to fully recover from an eating disorder varies from case to case.

For women who have difficulty resuming their periods after recovery, synthetic hormones may be used to supplement an otherwise healthy diet and lifestyle. The overall treatment for an eating disorder will typically involve a more holistic approach, including therapy, psychotropic medication and group support.

In addition to amenorrhea, women with eating disorders also suffer from a number of other symptoms that may interfere with their sex lives. Most obviously, low self-esteem and body image can prevent a woman from fully enjoying sexual experiences. Depression and anxiety often result in reduced libido or a complete disinterest in sex. Also, psychotropic medication can sometimes make it difficult to achieve orgasm.

Women with eating disorders certainly have the cards stacked against them when it comes to achieving full sexual health. This is why it’s important to actively seek help for any underlying issues and remain alert when you suspect someone close to you has a problem.