Eating disorders and menopause

Research suggests that up to 3.5% of people going through the menopause also have an eating disorder. How does one affect the other?

Hormonal and bodily changes experienced during menopause can change our eating behaviours and how we feel about our bodies. This can lead to eating disorders developing, coming back or getting worse.

What is menopause?

Menopause marks the end of fertility for people with ovaries. It’s typically diagnosed after 12 consecutive months without a period. It usually happens to those between the ages of 45 and 55.

This is split into three stages:

• Perimenopause: the small number of eggs left in the ovaries are released irregularly, which can lead to changes in frequency and flow of periods.
• Menopause: when periods stop completely.
• Post-menopause: a year after the final period.

What are the symptoms of menopause?

The menopause is a normal and natural part of the ageing process, but it can bring with it some challenging and uncomfortable symptoms. Not everyone will experience the same symptoms, but here are some common ones:

• Hot flushes: sudden feelings of warmth, usually in the face and upper body. These are often accompanied by sweating and redness.
• Mood swings: changes in mood can be caused by fluctuations in hormones, and some people may experience an increase in anxiety, depression or irritability.
• Memory and concentration problems: some report having difficulty concentrating or feeling foggy.
• Lowered libido: decreased interest in sex is common, and can be caused by hormonal changes or vaginal discomfort.
• Fatigue: the menopause can bring about a general sense of being tired or lacking energy.
• Disturbed sleep: difficulty falling or staying asleep.
• Joint and muscle pain: some experience aches and stiffness in their muscles and joints.
• Changes in hair and skin: thinning hair, dry skin or increased facial hair growth due to hormonal changes.

This list is not exhaustive, not everyone will experience all of the symptoms included in the list and some may experience symptoms that are not included in this list. Symptoms can also vary in frequency and duration.

How does the menopause affect eating disorders?

Menopause can significantly affect people with eating disorders. This is because the hormonal and bodily changes experienced during this time can change our eating behaviours, as well as how we feel about our bodies. Here are some of the ways eating disorders might interact with the menopause:

• Changes to appetite: The decline in oestrogen levels during menopause can cause changes in appetite. These changes may cause distress to people who have or are in recovery from eating disorders.
• Mood swings, anxiety and depression: Lower oestrogen levels are also linked to mood swings, and higher incidence of anxiety and depression. Disturbed sleep is also a common symptom of the menopause. Psychological distress may trigger the development, resurgence or worsening of eating disorder behaviours.
• Changes to physical appearance: Many of those going through menopause will see their bodies change. Weight gain or differences in body shape are common and can cause distress and potentially exacerbate eating disorder behaviours.

How can eating disorders impact the menopause?

It can be hard to spot menopause when you already have an eating disorder because a lot of the symptoms are similar.

Some eating disorders can cause the loss of periods and low oestrogen levels, which are similar to the effects of menopause.

Other symptoms of menopause similar to eating disorders include:

• Low mood, including anxiety and irritability.
• Disturbed sleep.
• Accelerated bone loss and increased risk of broken bones.

Sometimes it can be difficult to tell what’s related to an eating disorder, and what’s related to menopause.

If you’re unsure that you’re going through perimenopause, arrange an appointment  with your GP. Doctors will be able to offer you treatment if you choose.

Some studies have shown that some eating disorders can cause earlier onset menopause - however some people will naturally experience menopause earlier.

How might going through the menopause with an eating disorder affect my mental health?

Hormonal changes can cause increased risk of mental health conditions such as anxiety and depression, while eating disorders can also negatively affect your mental health. Unfortunately, this puts people experiencing them at an increased risk of suicide:

• One in 10 women report experiencing suicidal thoughts during the menopause.
• Women aged 50-54 have the highest rate of suicide in the UK.
• Studies have shown that eating disorders are associated with a significantly increased risk of suicide attempts.

If you are experiencing suicidal thoughts, please contact your GP or call 999 if you need immediate help. For 24-hour confidential support, contact the Samaritans by calling 116 123.

This sounds like me. What should I do?

Going through the menopause is tough enough without having the added anxiety of coping with an eating disorder. If you are - or suspect you are – experiencing an eating disorder alongside menopause, here are some things you can do:

• Contact your doctor: It’s really important to contact your GP if you’re struggling. Everyone’s experience will be different, but a healthcare professional will be able to advise you about how to take care of yourself and what the next steps should be for you. These might include taking hormone replacements like HRT to help address menopausal symptoms, or counselling for eating disorder symptoms.
• Explore additional resources and support groups: While it’s important to note that support groups and other resources are not a replacement for going to the doctor, you might find them helpful or comforting. There may be menopause support groups in your local area, and many resources are available online – just make sure they’re reputable. We’ve listed some great resources down below, and as always our Helpline is open to anyone experiencing eating disorder symptoms.
• Be patient and kind with yourself: What you’re experiencing is a lot to deal with. It’s so important to be compassionate with yourself, and recognise that recovery and symptom management may take some time.

What should I do if someone I love is experiencing this? 

Watching someone you love struggle can be really difficult, and sometimes it can be hard to know how to help. Your role is to provide support, not treatment – but we’ve compiled some tips:

• Experiencing menopause and an eating disorder together can be very challenging, and this is a time to be extra patient, kind and loving.
• Remember, changes or conflict in your relationship may sometimes be driven by the hormonal changes in menopause and an eating disorder.
• Keep informed by learning about what your loved one is going through.
• Make sure to take time for yourself.
• Show compassion and care, and listen without judgement.
• Avoid their experience becoming the focus of your relationship.
• Encourage your loved one to explore support options.
• And remember, our Helpline is there for you and your loved one if you need eating disorder support.

You can also find out more information on the NHS website.

Our Helpline is open every weekday for anyone who may be experiencing eating disorder symptoms. Support on our Helpline is available by phone, email, webchat  and letter. Our website also has lots of helpful information.

If you need urgent medical advice, please call 999 or 111.