Exercise and infertility in women

Dr Maxwell Adeyemi

Physical activities such as swimming, running, walking and dancing provides numerous health benefits, both physical and mental. But physical activity can be useful or harmful depending on the exercise regimen parameters: type, intensity, duration, aim, or structure. Physical activities promote health and quality of life, but excessive or strenuous exercise exposure can have detrimental side effects, among them fertility concerns in both males and females.

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse. There are various factors that influence fertility - age, health issues, reproductive organ issues, hormonal imbalances, sexually transmitted illnesses, and any form of fibroid or uterine growths are all examples.

Some lifestyle factors such as inadequate rest and sleep, smoking, alcohol, and caffeine may contribute.

Physical activity and infertility

According to some studies, many sportswomen may suffer reproductive dysfunction or menstruation issues, and girls who engage in strenuous activity often experience delayed onset of menses, cessation of menstruation, and long intervals between menstrual cycles. Infertility caused by high-intensity exercise may be reversed by reducing physical activity and increasing body fat.

Impact of extreme work outs on female

Increased level of cortisol: Prolonged exercise raises cortisol levels while decreasing thyroid hormone levels. Studies shows that even after 24 hours of recovery post-exercise, cortisol levels remained elevated and thyroid hormones suppressed. High cortisol levels and low thyroid hormone levels have both been related to poor adrenal health, which in turn has a direct impact on thyroid function and how the body handles stress in the long run, all of which can have a detrimental impact on overall hormonal balance and fertility.

Athletic hypothalamic amenorrhoea: Exercise-related ovarian dysfunction, also known as neuroendocrine dysfunction, can develop in athletes. Athletic hypothalamic amenorrhoea is the delay or cessation in the menstrual cycle in athletes. Exercise causes our brain to release chemicals such as beta endorphins and catecholamine. The release of these hormones rises with greater physical activity. A high level of these hormones interferes with the function of oestrogen and progesterone, which might lead to infertility in the long run.

Decline in gonadotropin releasing hormone (GnRH): This is a condition in which menstruation ceases for several months due to a hypothalamic issue. The hypothalamus is the brain’s reproduction control centre. After ovulation, it generates GnRH, which triggers the synthesis of other hormones required for egg maturation and ovulation, such as follicle stimulating hormone (FSH) and luteinising hormone (LH). These hormones then tell the ovaries to make oestrogen. Oestrogen thins cervical mucus and, in conjunction with progesterone from LH, prepares the uterus for a fertilised egg. Ovulation and menstruation will end if the hypothalamus slows or stops generating GnRH, resulting in infertility.

Low levels of body fat: The female body cannot menstruate if it has less than a particular proportion of body fat. A woman needs at least 22 per cent of body fat to ovulate and become pregnant. Most athletes lose a lot of body fat as a result of their training and will most likely experience issues with ovulation, which leads to infertility.

Emotional and mental stress: Strong, unpleasant emotions can have an impact on the hypothalamus, the region of the brain that regulates the reproductive system and menstrual cycle. This can cause a disruption in the connection between your brain and your ovaries, resulting in delayed or absent ovulation as well as irregular or skipped periods. Regular menstrual periods usually restart once your stress level has decreased.

Disordered eating: This could include fasting and skipping meals that is often practiced by people doing intense or rigorous physical activities. An energy deficit happens when a person consumes less energy than they expend. When there is a chronic energy shortage, the body’s mechanisms save fuel for important body processes. Less important bodily functions are suspended. This includes reproduction, which can be dangerous to survival. Energy and metabolic functions block the hypothalamic release of ovarian hormones.

While rigorous or excessive exercise can have negative effects on fertility, a healthy dose of regular physical activity may actually increase the chance of pregnancy.

Exercise has a number of health benefits for the average person, but for the woman trying to conceive, exercise may help eliminate or better manage some of the causes of infertility.

Reduced stress: Stress not only affect overall health, it can affect the ability to conceive. While stress does not directly cause infertility, it can push towards unhealthy behaviour that contributes to infertility like unhealthy eating, drinking alcohol and smoking.

Weight loss: Obesity has been linked to infertility with numerous studies suggesting obese women are more likely to experience reproductive problems, and if they do get pregnant they can experience a higher risk of miscarriage and delivery complications. A regular physical activity and weight loss programme with healthy diet can better manage this challenge.

Improved sleep: Regular exercise and physical activity promotes good sleep. While sleep problems are not direct cause of infertility, lack of sleep is linked to obesity which can affect fertility. Generally, women who get less than five hours of sleep each night are more likely to gain weight.

If you are an athlete or an avid rigorous exercise-oriented person, and you are experiencing fertility issues, it may be wise to conduct your health care provider for evaluation and assessment to see if this may be contributing to the condition.

Contact Dr Maxwell on 363-1807 or 757-5411.