Causes of Eating Disorder-Related Sexual Disturbances
There are a variety of factors that affect sexual function in the general population. So, what does that mean for individuals with eating disorders? Almost universally, those with eating disorders report that their illness has a negative impact on their sex lives, preventing intimate connections and undermining romantic relationships. It's no wonder that sexual dysfunction is on the list of problems caused by eating disorders, given the harm they do to the body and mind. Hormonal imbalances, malnutrition, underlying and related mental health issues, poor body image, and low self-esteem all contribute to sexual dysfunction. More than anything, it's a hard-to-miss sign of the grip eating disorders can have on our minds and bodies. Why do eating disorders affect sexual function so much? Let's look more closely at some of the potential contributing factors.
Sex life is regarded to be badly affected by low body weight in the general population because of the consequences of malnutrition. Low testosterone production, reduced levels of cervical lubrication, and a loss of libido are common in extremely underweight people. Eating disorders are hypothesized to cause sexual dysfunction in part because of the common tendency to maintain an artificially low body mass index. Prior to developing an eating disorder, many women reported having a normal sexual appetite, which suggests that eating disorders may directly or indirectly cause this decrease in sex drive. The loss of sexual desire experienced by women with anorexia nervosa is more pronounced than that experienced by those with other eating disorders.
As a result of low weight, women with anorexia are particularly susceptible to vaginismus, a condition characterized by involuntary tightness of the vagina. According to reports of women with vaginismus, intercourse can become uncomfortable and even painful, negatively affecting the ability to orgasm. The sexual satisfaction of women with eating disorders is frequently lower than that of healthy women partially because they have a harder time achieving orgasm. Combined, these adverse physiological effects on sexual functioning may make it difficult for women with ED to pursue, engage in, and feel satisfied with sexual activity.
However, these effects are present even when we are of average or above-average weight. When the brain itself is malnourished, regardless of body size or weight, it begins to lose functionality and slows down all extracellular processes in the body, including the reproductive system. The brain will gradually start to turn off the function of the ovaries in order to save energy for higher-priority processes. Estrogen and testosterone, the sex hormones that stimulate sexual desire and support the optimal functioning of the sexual reproductive system, are consequently reduced as a result of this.
The physical consequences of eating disorders are just the beginning. The central characteristics of an eating disorder, such as distorted body images, body dissatisfaction, and shame, all interfere with healthy sexual function. The emergence of other comorbid mental illnesses can make psychological issues that prevent sexual desire much more prevalent. The symptoms of depression, anxiety, anger, and disillusionment are more pronounced in women with EDs than in women without any disordered eating patterns. Additionally, women with eating disorders may avoid having sex simply because of the emotional distress that comes with the condition itself.
People with eating disorders are more likely to have a negative view of sex and sexuality. Because of this, they will often feel more sexual anxiety and less sexual pleasure. Many women with EDs have a skewed body image and are dissatisfied with their bodies, which can lead to sexual anxiety. Getting naked can be awkward since they worry about what their sexual partner will think. People who have a hard time feeling sexy may also have a hard time with their self-esteem and sexual confidence. Women with eating disorders often feel so bad about their bodies and so self-conscious that they are too afraid to be sexual and think they are not sexually attractive to their partner(s).
Because they generally do not feel as sexually competent as women with bulimia or binge eating disorders, anorexic women display the highest levels of sexual anxiety. This stress can manifest somatically. Anorexic women often describe unpleasant physical sensations they attribute to their anxiety. As a result of their heightened awareness of their difficulty in self-regulating, people who binge eat frequently display either extreme guilt or shame regarding their sexual desires. They may experience a reduction in sexual interest due to these emotions.
Disrupted sexual interests in women with EDs lead to decreased or inconsistent sexual activity, one of the behavioral effects of the disorders. Compared to healthy women, women with eating disorders frequently have fewer sexual encounters. There is an 80% reduction in sexual activity among female eating disorder patients compared to the general population of females. Women with bulimia or binge eating disorders report having more sexual experience and doing so earlier in life than anorexic women do. This discrepancy may exist because women who suffer from binge eating disorder or bulimia exhibit greater impulsivity, which is linked to hypersexuality—the practice of engaging in frequent, compulsive sexual behaviors to the point of causing stress. Stabilized sexual interest is generally absent from the lives of women who are severely bulimic. Nonetheless, they may experience a brief surge of sexual desire on occasion. Because women with EDs frequently struggle to maintain romantic and sexual relationships, they may engage in more casual sexual activity.
The current body of research indicates that EDs are linked to a reduction in the number of healthy sexual relationships. Compared to women who suffer from bulimia or binge eating disorders, anorexic women have the fewest sexual partners or relationships. However, bulimic women who are in sexual relationships report higher levels of conflict, instability, and decreased intimacy. Moreover, bulimic women who are married are more likely to divorce than healthy women.
When it comes to relationships and sexuality, anorexia nervosa sufferers are more likely to restrict themselves, while those with bulimia nervosa may use sex to meet the needs of their partner(s). Speaking about how their illnesses have impacted their sex lives, many patients receiving treatment for eating disorders describe how they were unable to truly connect with their partners when the disorder was at its worst. Relationships with their intimate partners may suffer as a result of an eating disorder, and those partners may feel hurt, angry, or frustrated when they realize this.
In addition to behavior with partners, sexual behavior also includes behavior with oneself. When compared to women without eating disorders, women with eating disorders report less frequent masturbation, which may be a result of their extreme body dissatisfaction. Compared to women with bulimia or binge eating disorders, women with anorexia masturbate less. Researchers think that anorexic women may abstain from masturbation because they frequently punish themselves by denying themselves any form of pleasure, including food and sex. However, because bulimic women do not deny themselves in this way, they are twice as likely to masturbate and have orgasms through masturbation as anorexic women. In general, women with eating disorders do not engage in typical sexual self-pleasure behaviors when compared to healthy women.
Whole-Body Effects Of Eating Disorders On Sexual Functioning
Physiological Effects
Low Sex Drive
Lack Of Vaginal Lubrication
Difficulties Reaching Orgasm
Vaginismus
Emotional Effects
Severe Body Dissatisfaction
Sexual Anxiety
Behavioral Effects
Less Sexual Activity
Less Sexual Partner/More Sexual Partners
Impulse Sexual Behavior
Interpersonal Effects
Reduced Intimacy
Increased Conflict
Do any of these effects surprise you?
What sexual effects have you experienced?
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