A case of symptom relapse post placement of intrauterine device (IUD) in a patient with bulimia nervosa: consequence or coincidence

  • Brad A. Mac NeilEmail author
  • Chloe C. Hudson
  • Kathleen Dempsey
  • Pallavi Nadkarni
Case Report


We report the first description of a case, to our knowledge and review of the literature, of a patient with bulimia nervosa (BN) who experienced a relapse in symptoms post-placement of an intrauterine device (IUD) during the later stages of her outpatient care.

A 26-year-old woman was referred to a hospital-based outpatient adult eating disorders program due to struggles with dietary restriction and engagement in binging and purging behavior twice daily to twice per week. The patient’s pre-treatment physical and psychological symptoms are presented in Table  1. The patient reported that she was sexually active, had a partner, and was taking an oral contraceptive pill daily (i.e., Alesse; levonorgestrel 100 µg plus ethinyl estradiol 20 µg). No issues with sexual health or functioning were reported by the patient. At intake assessment in January 2015, she met Diagnostic and Statistical Manual 5th edition [ 1] criteria for BN, severe intensity.
Table 1

Patient symptom...



The authors would like to acknowledge the contributions of the staff with the Adult Eating Disorders Program (AEDP) of Hotel Dieu Hospital including Sandra Leduc, RD, Cathy O’Brien, MSW, Kerry Oulton, OT, and support staff Tricia Barrett. Thank you to the patient who consented to take part in this case report as part of her care.

Compliance with ethical standards

Conflict of interest

The authors have none to disclose.

Informed consent

Informed consent was obtained from the participant who provided written consent to participate.

Research involving human participants

This study met ethical compliance and clearance through the local University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Brad A. Mac Neil
    • 1
    • 2
    Email author
  • Chloe C. Hudson
    • 1
  • Kathleen Dempsey
    • 1
  • Pallavi Nadkarni
    • 1
    • 2
  1. 1.Adult Eating Disorders Program (AEDP), Department of Adult Outpatient Psychiatry, Kingston Health Sciences Centre (KHSC)Hotel Dieu Hospital SiteKingstonCanada
  2. 2.Department of PsychiatryQueen’s UniversityKingstonCanada

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