The
image of the top athlete who trains hard enough to stop getting her period is
so familiar that many women are hesitant to exercise when they are trying to
get pregnant.
Some doctors don’t want to recommend exercise to patients who are
planning to conceive; some even warn against it. Although intense exercise can
cause women to stop ovulating, the newest research shows that moderate exercise
actually benefits fertility.
One
finding to emerge from the Nurses’ Health Study was a reduction in the risk of
ovulatory infertility with exercise. Hitting the gym three to five times a week
could bring the risk down by as much as 25 percent or more. Other, smaller
studies also have concluded that exercise improves fertility.
Larry and his wife had been
trying to conceive for many months with no luck. They appeared to be about as
healthy a couple as you’d ever meet—both were marathon runners. I (Sami) sent
Larry for a semen analysis, which revealed that his sperm count was low. I
couldn’t find anything else in either of them that could explain their difficulties
conceiving. My advice was to be patient until after Larry’s upcoming race. Sure
enough, once the stress of high–intensity training let up and the compression
shorts spent more time in the drawer and less time on Larry, his sperm count
went up to the normal range. Within a couple of months, he was officially a
father-to-be and back in training.
Regular
activity helps the body control blood sugar levels by burning off sugar in the
blood. That means insulin can work as it is meant to, without going to the
kinds of extremes that can interfere with ovulatory function and conception.
Exercise also helps keep androgens at appropriate levels so they will help, not
hinder, fertility. Exercise fights inflammation, too, decreasing the chances
that it can get in the way of conceiving. And exercise relieves stress, which
can improve fertility as well
Men’s
fertility also is affected by exercise: too much, too intensely has a negative
effect (though men generally have a higher tolerance for it than women do).
Moderate exercise is, however, a boon to good health, including fertility.
Serious long-distance runners (more than one hundred miles per week) may have
low testosterone levels while in training, enough to curb their sex drives and
potentially decrease their fertility. Distance cyclers (more than fifty miles
per week) may have reduced sperm production. (With bicycling, it’s not just the
stress of intense exercise but also the bicycle seat and even the bike shorts). When not done to these extremes, exercise is a positive choice,
and fertility is soon restored when men in particularly intensive training tone
it down a bit.
What You Can Do About ItThere’s no reason not to exercise when you are trying to conceive. Normal exercise will not impede fertility, and we all know it’s a key component of weight control, making it key for optimum fertility as well. The bottom line is, exercise is good for you. So just do it! You are more likely to have fertility problems traceable to obesity and a sedentary lifestyle than to overdoing it physically.Our general recommendation for exercising to maximize fertility is pretty much the same as for exercising to maximize overall health. Most people should try to get at least thirty minutes of moderate exercise almost every day—more if they are trying to lose weight—and vary their activity so they get aerobics, strengthening, and stretching out of the deal. If you haven’t been exercising regularly or at all, now is an excellent time to start. But start slowly and gradually build up so as not to stress your body. For women who are certain fertility types, some kinds of exercise are more appropriate than others. See part V for the Making Babies Rx for each type.
Case Study: Martha
Martha had no trouble getting pregnant
the first time around. She and her husband wanted a second child, but after a
year of trying, she still wasn’t pregnant. (This “secondary infertility” is
particularly perplexing to doctors.) Sure, Martha was three years older than
she was the first time, but I (Sami) discovered that it was another change in
her life that was causing the problem: she’d begun taking an intense aerobics
class four times a week.
The endorphin rushes from her intense workouts were
lowering her progesterone level so far that although she was conceiving, she
was actually miscarrying before she even knew she was pregnant. She was still
getting her period regularly, so she never suspected she was overdoing it. I
explained that there’s a gray zone where the cycle doesn’t obviously change,
but intense exercise makes it harder to get pregnant and more likely that a
woman will miscarry. As she thought this over, Martha realized that when she
got pregnant with her first child, she’d been in the middle of a really busy
stretch at work and had temporarily given up going to the gym. So Martha scaled
back. She didn’t give up the class, but she did slow down a bit, and she never
pushed herself to the point where she got that endorphin rush. That was all she
needed to do. She easily got pregnant (and stayed pregnant)–twice!–with no
further help from me.
You
can keep tabs on how much exercise is too much for you not by the number of
minutes spent exercising but by the intensity. Exercise should make you feel
good, physically and emotionally, not completely drained or exhausted. While
you are trying to conceive, stay away from your peak exercise level. If you
exercise to the point where you get that endorphin rush, the socalled zone,
scale back. That rush is a sure sign you’re overdoing it from a fertility
perspective.
Estrogen
levels decrease in women when they really push themselves physically—enough to
potentially stop ovulation—so it makes sense for those who frequently exercise
intensely for extended periods of time to cut back a bit. Now is perhaps not
the time to go into training for a competitive marathon. Hormone levels and
menstrual cycles will return to normal when women stop doing such intense
exercise, so this is a problem with a simple solution.
In
women with very low body weight, even less extreme exercise can negatively
affect ovulation. Lean women need to be sure to keep “moderation” as their
watchword when it comes to exercise. But that’s good advice for all women
wanting to conceive. When it comes to exercise, don’t overdo it.
Exercising Through Your CyclePhase 1 (Menstruation)• Avoid strenuous aerobic exercise during your period.• Try workouts with a meditative bent, such as yoga, tai chi, or qi gong.Phase 2 (Pre-ovulation)• Spend twenty to thirty minutes a day on aerobic exercise.Phase 3 (Ovulation)• Exercise gently; try swimming, walking, yoga, or qi gong. Avoid exercise that involves high impact, such as running or step aerobics. Exercise gets the blood moving, which encourages good blood flow to the uterus, so it’s particularly beneficial around ovulation.Phase 4 (Potential Implantation)• Get moderate exercise to keep the qi and blood moving after ovulation, when an embryo may be trying to implant, but avoid intensely aerobic exercise or high-impact exercise, such as jogging or trampolining (unless you are sure you are not pregnant). Walking, cycling, swimming, yoga, and qi gong are all good choices.
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