Sudden Menstruation Devastates Me

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This is a post I am making in lieu of my cousin who is struggling with an ED. She is too terrified to disclose her name or other details, and I have agreed to create this post under my account so she feels safe about maintaining her privacy. She has written out her thoughts and fears below:

I am 38 and have been battling anorexia since I was in my late teens. In my early 20s my periods became erratic. Sometimes I would skip a few months (or years) and then they'd return and then leave again. By the age of 24 it went away and never returned. Over the years I've been working to maintain being "underweight" though functional. I have NOT gained weight or changed my diet. If anything, I've become even more restrictive. I continue to exercise excessively and when I do eat I limit myself to "safe" foods.

Anyway, within the last few years I had reason to believe I was entering premature menopause (my mother, who was NOT anorexic) started menopause in her 40s so it is the family norm to do so. Even though I know that amenorrhea in eating disorders is NOT permanent, but given that I went 14 years without a cycle and was so close to menopause I assumed I would transition without its return. Plus I assumed with all the longterm restriction and bodily abuse that any eggs I had would be gone by now. But alas, Thursday evening I started spotting. While I do not have a "flow yet" it seems as though my menstrual cycle has decided to return after all this time.

I am completely DEVASTATED because I have NO CLUE why this has happened. I have NOT recovered. I have NOT gained weight. I am NOT consuming more calories. If anything, within the last week I've actually been restricting myself even more and exercising more--renewing my commitment per the new year to NOT gain weight as I age. While I know I should not connect loss of menstruation with weight gain, I can't help but feel this is a failure on my part. Somehow I must have gained weight but how? I am so obsessed and depressed and feel I need to exercise and starve even more. Can someone please explain to me why my period has returned? Is this hormonal. I am so SO upset by this.

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