I have a question regarding menstruation and hair loss related to anorexia. I am 37 and have not had a period for 16 months. I am losing large amounts of hair. At first, I was told the hair loss was telogen effluvium, a temporary condition, and told to gain weight before trying hormones for my periods. I am now 2 pounds above the weight I had been for years when these were not problems. However, still no periods, and even more distressing, I’m told my hair loss may be hormonal and permanent. My question is, can these problems work themselves out once they start, or have I ruined myself permanently? Also, is hair loss common in eating disorders? It has been ongoing for a year. I have always been thin and struggled with anorexia off and on, but at a “normal” weight according to my own history, I am very worried that I will be hormonally dependent with little hair for the rest of my life. As a side note, I have added about 400 calories a day to my diet recently, hoping it might help jump start my hormones eventually. Thanks so much. Your site is a blessing! – anonymous
Dear Anonymous,
Your question leads to a lot more questions for me as a medical doctor. First of all, I am wondering if the weight you are at is a healthy weight or is it a weight you have had with chronic anorexia?
If you are truly maintaining a healthy weight with normal body fat (17-25%), the hair loss, if caused by the eating disorder, should be resolving. Also, if in a healthy body weight range, your periods should have resumed by now if caused by the eating disorder. Keep in mind, it can take 6 months after reaching a normal body weight for your menstrual cycle to resume.
Hair loss is common with an eating disorder, but it is more a gradual thinning, rather than loss of large sections of hair. Many women will say they noticed their hair thinning, but it is not typically large clumps or baldness.
The adding the 400 kcals a day is a good move. That should help with normal hormonal balance.
It is also important to make sure you have had a good laboratory work-up. Problems with thyroid can cause hair loss and problems with your period.
Best wishes,
Brenda K. Woods, MD, FAAFP