Anorexia Nervosa & Sexual Dysfunction.

The disturbances in sexual function come from many places. These include hormonal imbalances, malnutrition, underlying and accompanying mental health conditions, poor body image, and low self-esteem.

This post has sexual themes. Although not explicit, be aware that I’ll be discussing intimate details in an attempt to raise awareness.

There are many things we don’t discuss in relation to anorexia nervosa and the impacts on our bodies. Constipation from malnutrition, the use of laxatives, and the growth of downy hair, are among the few lesser-known results. Even lesser still is the impact that anorexia nervosa has on the sexual dysfunction of women.

As a gender, women are less likely to discuss sex and sexual issues than men. I’ve never spoken to my therapist or physician about my lack of libido and pain during intercourse. The embarrassment of admitting that I hadn’t had sex in over six months is much too daunting. Ultimately I fear their judgment of both my relationship and myself, therefore I’ve kept it a secret.

“For a long time, I thought I was alone. I choose to blame the pituitary tumor or my upbringing. But after I came across an article discussing sexual dysfunction and anorexia I discovered that I wasn’t alone.”

The disturbances in sexual function come from many places. These include hormonal imbalances, malnutrition, underlying and accompanying mental health conditions, poor body image, and low self-esteem. More than anything, it’s a symptom of the deep, psychological, and physiological hold that eating disorders can have over us. 


Physiological impacts on sexual functioning.

Although sexual dysfunction in individuals with eating disorders is widely under-researched (Gonidakis, F et al 2016), the studies available show a correlation between the two. Specifically with that of anorexia nervosa. 

Considering the negative impacts that eating disorders have on the body and brain, it comes as no surprise that sexual dysfunction is included on the list. Research has shown that anorexia nervosa is prevalent in the majority of cases. In fact, a 2012 study of 242 found that over 66.9% of women experiencing an eating disorder reported a decrease in sexual desire (Pinheiro,etc,2010). This is thought to be due to the maintenance of a low body mass index (BMI). In the general population, low body weight is considered to negatively impact our sex life due to the effects of malnutrition (Pinheiro,etc,2010,Castellni,etc, 2012)

When the brain is starved of nutrition it starts to lose function and slows down all non-essential systems within our body. This includes the reproductive system. As a way of conserving energy for priority functions, the brain will gradually begin to shut off the function of the ovaries. In turn, this causes the reduction of the sex hormones, oestrogen and testosterone which are responsible for creating sexual desire, and promoting the healthy operation of the sexual reproductive system (NEDA, 2018).

Sex can become unsatisfying and even painful due to reports of vaginismus, wherein sex is painful due to a lack of lubrication and unnatural tightness. It’s thought that this also contributes to the inability to reach orgasim (Haimes A.L et Katz J.L, 1988).

“With all of these physiological issues going on within the body, women with anorexia often find themselves discouraged from any sort of sexual activity (Pinheiro, etc, 2010).

The negative side effects of anorexia on sex are not only limited to the physical. In fact, the psychological issues preventing sexual desire can be even more prevalent, with the onset of depression, anxiety, and other mental illness (Pinheiro, etc, 2010). The prevalence of mental health issues is well documented for contributing to a lowered libido, and with the likelihood of medication, this lack of sexual desire can be expected to increase (Julie Corliss, 2017).

Women with anorexia nervosa often suffer from distorted body image and body dissatisfaction, which can create anxiety surrounding the act of sex. This is apparent in Pinherio’s study wherein it was discovered that of the 242 women studied, 59.2% reported feeling sexual anxiety(Pinheiro, etc, 2010). Quite often they feel embarrassed to get undressed for fear of what their sexual partner will think of them.They may also struggle with confidence, and the sexual confidence which is needed to feel ‘sexy’.

The lack of sexual interest is not limited to activity with sexual partners, this also includes activity with themselves. There were lower levels of masturbation reported among women suffering from Anorexia Nervosa (Calogero & Thompson, 2008). Again, this could be deemed down to the impacts on hormones, and the severe body dissatisfaction. 


Stop hiding it, start talking about it.

Sexual Dysfunction among women with eating disorders is a well-kept secret. We hide, preferring to keep it to ourselves than to discuss our sexual issues for a variety of reasons, stigma is one of the biggest. Talking openly about it, whether it’s online or in therapy, helps spread the word that this isn’t a unique issue. 

The important thing to remember is that the majority of women who have experienced sexual dysfunction reported relatively normal sexual functioning prior to the onset of the eating disorder (Ghizzani & Montomoli, 2000). It’s therefore thought that with the restoration of the body to a normal BMI, sufferers should start to see the return of normal sexual desire and functioning. 

However, it’s not as simple as fixing our bodies. The mind clearly plays a big part in assisting our sexual function, and can often be a critical part of promoting sexual desire. Although the body may be restored to regular weight, allowing for the production of hormones, the mind can take around six months to one year to follow suit. It may take work in regards to building confidence, self-esteem, and letting go of past assumptions to coax our minds into healthier thinking patterns.

Finally, sex drives differs from one person to the next. Even those of a healthy BMI have differing sex drives; That’s okay. Having a naturally lower sex drive is nothing to be ashamed of in our currently hypersexual culture, and it shouldn’t be something you should ever be shamed for. 


References.

  • Fragiskos Gonidakis, Vassiliki Kravvariti, Melissa Fabello, Eleftheria Varsou. (2016). Anorexia Nervosa & Sexual Function. Current Sexual Health Reports. 8 (1), pp19-26.
  • Andréa Poyastro Pinheiro, M.D., PhD.,1 TJ Raney, PhD.,1 Laura M. Thornton, Ph.D.,1 Manfred M. Fichter, M.D.,2 Wade H. Berrettini, M.D.,3 David Goldman, M.D.,4 Katherine A. Halmi, M.D.,5 Allan S. Kapla. (2010). SEXUAL FUNCTIONING IN WOMEN WITH EATING DISORDERS. International Journal of Eating Disorders. 43 (2), p123-129.
  • NEDA. (2018). Common Consequences of Eating Disorders. Available: https://www.nationaleatingdisorders.org/health-consequences. Last accessed 31th May 2019.
  • Haimes, A. L., & Katz, J. L. (1988). Sexual and social maturity versus social conformity in restricting anorectic, bulimic, and borderline women. International Journal of Eating Disorders, 7(3), 331-341.
  • Julie Corliss. (2017). When an SSRI medication impacts your sex life.Available: https://www.health.harvard.edu/womens-health/when-an-ssri-medication-impacts-your-sex-life. Last accessed 31st May 2019.
  • Calogero, R. M., & Thompson, K. (2008). Sexual self-esteem in American and British college women: Relations with self-objectification and eating problems. Sex Roles, 60(3), 160-173.

42 comments

  1. This is such an interesting topic. One simply does not associate anorexia with sexual health because it’s overshadowed by so many other factors. Thank you for writing about this personal thing, and educating your readers.

    All the best, Michelle (michellesclutterbox.com)

  2. I have struggled on and off with this throughout my teen and adult life due to my eating disorder and the thoughts/feelings that it triggers. That being said, you’re right – it’s one of those topics that we all hide and avoid talking about. Thank you for bringing it to light and pulling back the curtain on such an important topic!

  3. I don’t think I’ve ever seen a blogger discuss this so thank you for opening up and sharing such an insightful post, I had no idea. It’s always good to start the discussion and raise awareness so I hope others continue talking about important topics like this. Thank you for sharing and starting the conversation

    bumblingalong.co.uk

  4. I wouldn’t be surprised either. It really takes its toll. I suspect I’ll be popping in and out of therapy for years to come, if not for severe intervention, for a top up of sorts.
    Thank you for reading.

  5. Thank you so much for reading and commenting. My sexual issues stay between my partner and my best friends, and now, I suppose, my readers!

  6. Thank you pet! It was very jarring to write about but necessary. Like you say, I’ve never seen anyone else cover this other than my previous guest and I had this written months ago with the intent to put it out now during Sexual health awareness.

  7. Thank you so much for taking the time to read and comment. I found this incredibly intimate to write about but it’s a very real part of recovery.

  8. Thank you so much for sharing this! Really!

    I suffered with anorexia for around 8 years and would hate the thought of getting intimate with anyone as my hip bones stuck out as well as my collarbones and ribs and I knew it wouldn’t feel comfortable to have sex with me basically as I was skeletal.

    It’s so important to talk about things like this so thanks for sharing!

    Love Lozza x
    http://girlygabble.com

  9. This information is so important to talk about. As a female, I know it is not talked about enough and I’m glad you started the conversation.

  10. I think that anyone who has anorexia has a negative effect on many aspects of their lives including their sex life.

  11. I was not aware of this correlation, but it makes sense. I hope this post will help people who were too embarrassed to seek the help they need.

  12. Anorexia is something that most people don’t want to bring it. It is great you are bringing awareness to it and that it comes with other symptoms. This is a very important topic.

  13. I think this is a very important topic. Anorexia is no joke. I know some who have suffered from this. I just hope most are able to get the help they need.

  14. I’ve learned a lot from your post. I have heard of anorexia before but I don’t personally know anyone who’s suffering from it. Thank you for sharing.

  15. I didn’t really know it affected people in that area. Thanks for helping to educate, as always. You are a wonderful advocate, not just for those with ED, but women in general!

  16. I didn’t know that anorexia nervosa has such a negative impact on our life. Thanks for telling us about!

  17. I had never considered how anorexia would effect feelings of sex and intimacy. Thanks for the information and discussing this topic.

  18. When I was in junior high school (many, many, many years ago) my friend had anorexia. People don’t realize the psychological impact it has on a person. The physical impact is obvious but my friend had counseling for many years afterward. I wouldn’t be surprised if she is still going for counseling and she’s in her 50’s.

  19. This was an amazing read. Of course, I’ve heard of anorexia and even seen it, but in ever thought about this aspect of it before.

  20. I’ve never seen any blogger talk about this subject so thank you for raising awareness of this! Although I don’t suffer from this, it’s so important to raise awareness and help others x

  21. I’ve never seen anyone talk about something like this so publicly. But it happens, and it’s something that needs to be talked about.

  22. This is something I’ve never even thought about before but now that you’ve discussed it, it’s like an aha moment.

  23. You know, I don’t think I’ve EVER seen a blogger talk about this. So thank you for sharing and I’m sure this is going to help a lot of people and also open the eyes of a lot of people – like me – who didn’t realise (stupidly) that the two would be quite so closely linked. It’s really quite obvious after reading about it.

  24. Yikes… I can definitely see how one can leak into the other. It makes me so sad and hopefully for those that are suffering. And hopefully one day there will be more research on the subject.

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