Conceiving with a history of anorexia

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I am not yet TTC but would like to start trying in the next year or two but I am worried about it due to my history of anorexia.

I am 31 and now in recovery, but was pretty severely underweight from the ages of 13-26. Since the age of 26, my BMI has fluctuated between 18 and 20.1, it is currently 18.6.

I realise I could probably do with gaining a little more weight, but I never regained my menstrual cycle even when I was heavier, therefore I have not had a natural period for 16 years, which is pretty scary really.

I have expressed my concerns about conceiving to my GP, rheumatologist and endocrinologist and they dismiss my worries and have put me on the pill (suppressing my natural oestrogen) for my bones and say we can address the fertility issue when I am actively TTC by referring me to specialist clinics etc.

Has anyone been in a similar position and either conceived naturally or been given similar advice? It just doesn't sit right with me and I am worried that I may have really damaged my chances of conceiving.

My mil has anorexia. She's got thinner over time but from photos its always been an issue

She has two robust intellligent and healthy children fairly late in life. (32 and 37) No health issues and both went to oxbridge despite her not eating and ending both pregnancies weighing less her pre-pregnancy weight (she tells me that story with pride regularly normally as i scoff another biscuit)

Kids are fine but she is not. Her bones are totally shot though and shes said she'll likely get dementia.
Listen to your doctors and look after your bones.

I know a lady who is still anorexic (60 this year) she conceived a healthy baby (her first) aged 46 after years of believing she was infertile.

I know someone who battled anorexia from her mid twenties. I'm not saying that you'll need to do this, but I do suggest to go to a fertility clinic and have some basic tests, check your hormones and eggs. For my friend the anorexia damaged her eggs and the only way she could get pregnant was through donor ivf. Not saying that will be your case but going to a fertility clinic will be a good place to get some basic answers.

I was anorexic for many years and concieved three times the first month of trying. However I was a healthy weight by then and my periods had returned so I suggest for now you focus on putting on more weight.

I'd add to the recommendation to focus on recovering your period - I have a history of anorexia in teens, had recurrent issues in my late 20s where I lost my period for 6 years because of overexercising. The only way it came back was when my BMI was at 23-24, from what you said yours didn't go above 20 and is quite low at the moment so I'd focus on that. It may involve being heavier than you want to be and pulling back on exercise but worth trying especially to address the osteoporosis risk.
I found that doctors didn't have much clue about the link between lack of periods and eating disorders/disordered eating, I was told to just take the pill and that my period would not return naturally ever again and not to bother with lifestyle changes. You may find the book "No period now what" by Nicola Rinaldi helpful, this is what convinced me to increase my BMI and decrease exercise.

Thank you very much for all your replies. Fertility testing is a good idea and I think I will probably need to put on more weight, as much as I'd rather not! I find the doctors' lack of knowledge in this area very frustrating.

Putting aside whether or not the anorexia has affected your fertility, how will you cope with the necessary weight gain that comes with pregnancy? Even women with healthy relationships with food struggle with it

I'm not anorexic, but I am decently underweight (highest BMI has ever been I believe is 16.9 or something) and I've conceived no issue, even with irregular or absent periods.

Have you confirmed you ovulate regularly? Though if on the pill you won't really be able to check.

There’s a dietitian called Renee McGregor who talks about hormones / periods etc in the context of people with restrictive eating behaviour - she has a website - might be worth a look?

Rtmhwales; the situation of someone who has always been naturally underweight versus a woman who has experienced an eating disorder is very different when it comes to impact on fertility. Eating disorders can have a profound impact on disregulating the body when it becomes very sensitive whenever there is an energy deficiency which is one of the reasons why it sometimes is necessary to go up to a higher weight and stay there for a while to allow the body to stabilise. Unfortunately there isn't much understanding of that amongst the medical profession, at least in my experience.

I second getting fertility testing privately now rather than leaving it potentially too late.

@GreenLunchBox you raise a good point. Weight gain makes me uncomfortable but I have coped with it so far by rationalising that it has given me a body that allows me to live a full life including having meaningful relationships, celebrating occasions which inevitably involves food, being able to have a career etc. I plan to use the same approach when gaining weight to become pregnant and whilst pregnant eg I may not like gaining weight but it gives me a body that is healthy enough to carry a child etc. Obviously it is not always that simple and I do go through mental gymnastics every day to keep myself on the right path but that is my plan for now.

@Blondie1984 thank you very much, I'll take a look

I agree that private testing is a good idea. You can get it for around 5-600 quid. It will help you think about what you'd need to consider.

Congratulations on your recovery so far and for working so hard towards what you want xx

@TheDaydreamBelievers what a lovely message, thank you so much!