trying to conceive with an eating disorder

[smoothie844]

Hi Dr B.-
I was wondering if you could offer me any advice.  I am 25 years old and happily married.  Since I was 15 I have suffered from bulimia.  My periods have been very irregular since I was 15 and began to have eating issues.  I conceived my son who is now 18 months old and healthy when I was 23 when not even trying.  I missed taking by birth control pill for 4 days by mistake.  I thought at the time that I couldn't even become pregnant because I went over two years without even having a period because of my eating disorder.  So now I am trying to conceive again with no luck.  I have been trying for 7 months.  I am 5 foot 2 and weigh about 105 lbs.  I again , am not having a period as i have not been taking birht control pills to induce menstration.  Does you have any experience in your practice with this??  Could I have ruined my chances of getting pregnant forever becasue of myeating disorder?? I am waiting to see my doctor about this problem as I have never had the courage to tell him about my eating disorder- but i can't get in to see him for another 2 months.  I am a geriatric nurse practitioner myself so i can understand advice that you can give me if it is not in laymens terms.  I have no formal training in ob/gyn field.  Please help me.  Just a little other info on me that you may or may not need to know about my pmh:  I am healthy and have no medical problems other than my ED, and am on no medications.  I had a healthy pregnancy and my son weight 7 lbs when he was born and he is very healthy and active now.  It was a full term pregnancy and easy delivery with no complications.  I had a mirena IUD Placed in July of 07 and had it removed about 7 months ago

[Elaine Brown, MD]

Hi!
It is very likely that you are not ovulating regularly.  This may or may not be a consequence of your eating disorder.  The one can certainly cause the other, but the other can happen even without the first--if you follow me!

I have had good luck with Femara.  You could take a progesterone to induce a period, but what you really want is something to induce ovulation, and I have had better luck with Femara than with Clomid which is the old standard therapy.

You should have your thyroid and prolactin levels tested too if you haven't already.

You certainly haven't ruined your chances forever!  How did your eating disorder fare while you were pregnant?  Some people have a really hard time with the weight gain, but most of my patients have done very well.

You probably don't have to tell your doctor about your ED, just tell him you're not having periods, but if you did tell him, I'll bet he'd be understanding--give him some credit!

Good luck!
Hope it all works out!

Dr B

[smoothie844]

thanks dr brown- it makes me feel more confident.  I did very well with my ed during my first pregnancy.  however i quickly relapsed postpartum- thats why i am worrying so much now if i permanently screwed things up with being able to conceive again.  I will talk to my doctor as soon as i can thank you!!