Let's Talk About Sex... Hormones!

 Yep... I'm going there.

Why? Because it's such an important topic that is usually missed, forgotten or quietly ignored when we discuss eating disorders and how they can affect our bodies; especially with predominantly (cisgender) men who have eating disorders.

Being a cisgender man with an eating disorder, this is something that was missed, time and time again, and has had huge effects on my life and - potentially - my future.

When I filled in my first questionnaire about my eating disorder for my GP, one of the questions was "Women only: Have you stopped having periods". Of course I skipped over that question, it didn't apply to me so obviously issues like that wouldn't affect men, right?

Wrong.

Firstly, I want to point out that most people who mensurate will not lose their periods because of their eating disorder, and I don't think it should be used as a criteria to allocate treatment or who is "worse", as eating disorders affect everyone in vastly different ways.

However, where was the question for people like me? Someone who doesn't menstruate but should naturally produce testosterone in order to develop as a man? The simple answer is that it didn't exist, it's not mentioned anywhere. But that doesn't mean that it doesn't affect us.

Between the ages of 11 and 15, as I explained in my previous blog, I didn't grow, I didn't develop. Yet no one noticed, no one did anything. Why?

The upshot is that I am now permanently stuck somewhere between a 12-15 year old's body (yep, turns out an endocrinologist can work that out by manhandling your bollocks and using something that looks like a morbid necklace).

All of this because of a lack of understanding of how eating disorders can affect sexual hormones. It's not just testosterone I've lost either, it's also FSH, LH and Estrogen (yep, turns out men need that too!). But even for people who menstruate, the context of sexual hormones is clouded in stigma. It's seen as almost a cut-off for severity for many-an-ignorant physician. The truth is this:

Loss of menstruation or loss of testosterone is NOT necessarily a marker of eating disorder severity

It's yet another legacy aspect rooted in weight stigma and bias, but even for those who are underweight, they may still not lose their hormones. Bodies are weird and wonderful things and there is never a one-size-fits all.

But for those who do lose their hormones, it can have serious, life changing and  - potentially - life limiting effects, such as:

• Osteoporosis
• Frailty in older age
• Infertility
• Lack of physical development
• Stunted growth
• Liver and heart complications
• Struggle to gain muscle mass and conditioning (which can be a vital part of recovery for some)

And probably a lot more we still don't really understand or know yet.

So... what were the signs for me? Some of these are taboo subjects, but I am going to go there because it's important.

• Loss of my morning erections. Yep, it might be a "taboo" subject, but it's a NORMAL THING. If you stop having them, it could be a sign.
• Even more taboo... yep masturbation. My body stopped producing seamen. You might laugh reading this, think I'm oversharing. But I wish I'd known it was a sign something was really wrong.
• For teenagers, stunted growth/development.
• Tiredness, agitation, and feeling generally unwell.
• Unable to gain muscle despite trying.

Please don't ignore if you're experiencing symptoms, there is medication which can help out and prevent long-term health issues and damage which could be caused by a loss of sexual hormones.

Mine have buggered off for so long that they may never come back, I don't want others to have the same outcome. We need to talk more about this to stop others having long term damage, and we HAVE to get early intervention for eating disorders better. 

Prevention is ALWAYS better than a cure.