More and more women these days are training like athletes, honing their physiques with daily HIIT sessions — sometimes back-to-back classes — as well as a string of challenges and races combined with spartan nutrition. According to Dr Rosalie Sant, an obstetrician-gynecologist at Primavera Medical Centre in Dubai and a member of the livehealthy.ae expert panel, the combination is not a good recipe for getting pregnant.
How can rigorous exercise regimes impact fertility?
Yes, they may. You see, although they think they are super-fit and therefore healthy, their body perceives them as not being that at all. It may think that their life is too tough and food too sparse for them to safely carry a pregnancy. Therefore, for the sake of self-preservation, their fertility shuts down. Their lifestyle is so extreme, with long-term strenuous exercise and restrictive ‘healthy’ eating, that pregnancy is perceived as a threat to the woman’s health and well-being. As a result, the body will shut down the reproductive system as a pregnancy will be an additional ‘stress’ to the system that the woman’s body cannot cope with. Periods may or may not stop but regular ovulation stops and therefore the women will not get pregnant.
How can you help these people?
There are many reasons why periods stop or become irregular. The most common reason and therefore the most spoken about, is polycystic ovary syndrome (PCOS). People know of this condition and know that the treatment for this is exercise and healthy eating. So, these athletes embark on an even more intense ‘healthy’ regime, thinking that this may help their fertility. But this only works if they have PCOS. If periods stop because they are super-fit and have multicystic ovaries, then this new fitness regime will only make things worse.
The problem is, even when we show them that being super fit is actually the reason for their issue, it is difficult to persuade them to revert to a more balanced lifestyle. Over the years, I’ve had varying degrees of success in these situations. I’ve had somebody who would not believe me and then had an Achilles tendon injury. This stopped her from exercising for a few months and, sure enough, her periods started again.
I also have another lady who did believe me. I am very proud of her, actually, because, even though it took her about a year to find the right balance for herself, not only did she manage to get her periods again but also to naturally get pregnant without any medical intervention whatsoever, except advice and encouragement. She maintained the sports/nutrition balance even after her pregnancy so her periods came back as soon as she stopped breastfeeding, and she had no problem at all with conceiving her second child.
In addition, some women use exercise as their stress relief, so it is very difficult for them to cut back. Counseling and alternative stress management techniques may be needed to help them find a healthier balance.
What if women don’t take your advice?
The super-fit women who do not accept the advice or help in moderating their lifestyle can end up having to go to fertility clinics for IVF. However, even then, the ovulation stimulation medicine may not work, as their system is so severely shut down. They find this very difficult to accept because, to stimulate the ovaries, it’s not a higher dose of hormones that they may need, but a completely different type of stimulation that works on the hypothalamus and the pituitary gland that has shut down due to their extreme lifestyle. They really do need to tone down their fitness regime for any medicine to work.
So they are working against themselves?
The sole purpose of the body is to look after you. If you, through your life-style, are giving your body the impression that your life is too tough and difficult, then it won’t allow you to get pregnant. It’s actually pretty simplistic, but that’s exactly what happens. People find it difficult to understand that it is simply self-preservation.
What other problems can arise from ‘too much’ fitness?
If their estrogen levels are low as their ovaries are shut down, then they develop bone loss that can lead to osteoporosis, faster aging of the arteries of the heart, faster overall aging and any other symptom of inadequate estrogen levels.
• This interview ran originally in July 2020.
Ann Marie McQueen
Ann Marie McQueen is the founding editor-in-chief of Livehealthy and host of The Livehealthy Podcast. She is a veteran Canadian digital journalist who has worked in North America and the Middle East. Her past roles include features editor for The National, trends writer and columnist for the Canadian newspaper chain Sun Media, and correspondent for CBC Radio.