The broader implications of menstrual health in eating disorders: matters arising from Porter (2025)

Menstrual disturbances are a common yet often overlooked feature of eating disorders, impacting individuals across diagnostic categories and age groups. This Matters Arising piece responds to Porter (2025), a survivor-led qualitative study highlighting that menstruation is often treated as a simple health indicator, with little attention to emotional or psychosocial aspects. Specifically, I discuss broader intersections between eating disorder pathology and menstrual health, including functional hypothalamic amenorrhea, oligomenorrhea and menopause-related changes, illustrating how menstrual irregularities reflect disruptions in hormonal and metabolic regulation and carry psychological and identity-related implications. Current clinical approaches frequently overlook these dimensions, focusing narrowly on the presence or absence of menstruation rather than holistic well-being. Drawing on research evidence and clinical experience, I recommend a patient-centred approach that includes routine assessment of menstrual history and symptoms, integration of menstrual considerations into nutritional, medical and psychological treatment plans and sensitive communication regarding emotional and identity-related experiences. Interdisciplinary collaboration and further research are essential to better understand menstrual experiences across the lifespan. Recognising menstrual health as a meaningful component of overall treatment can enhance recovery and provide more comprehensive, empathetic care.