Impact of exercise and body weight on menstrual cycle health

Exercises that evidence has shown could potentially impact on fertility include:

Going through strenuous training for an endurance event can disrupt the cycle, but evidence indicate that normal cycle function can be regained over a 6 month period once the strenuous exercise finishes.

Why does some exercise impact menstrual function?

Following a review of the research Barbara Drinkwater explains that 3 theories have emerged to explain the link between strenuous physical exercise and menstrual dysfunction:

  • decrease in percent body fat
  • hormonal fluctuations resulting from sustained intense exercise
  • physiological stress

The review goes on to say that body weight alone may not be sufficient to explain the dysfunction in menstruation.  Three separate studies reported no significant difference in the weight or body fat of runners who had normal cycles as compared to runners who lacked periods.  Also, the menstrual health of ballet dancers improved during holidays and breaks from training despite there being no major changes to their body weight or composition, indicating that it is the strenuous exercise, and not body weight, that impacts the cycle.

have demonstrated that individuals with highly variable cycles or amenorrhea (lack of a period) tend to weigh less, to have lower body fat percentage, and to report more weight loss than women with normal menstrual cycles. 

High and moderate levels of physical activity can alter menstrual function. Al- though the frequency of menstrual disturbance among athletes varies considerably across studies, women athletes, particularly ballet dancers and runners, have a greater frequency of amenorrhea, anovulation, and luteal phase defects than nonathletes (26, 69, 73). Recreational exercise decreases mean menstrual cycle length, the probability of having a long menstrual cycle, and the probability of anovulation in school girls (27, 28). Data on training intensity are inconsis- tent; however, the reported frequency of amenorrhea is higher in studies of competitive athletes than in studies of recreational runners. Apparent discrepancies in the literature are largely attributable to divergent defini- tions of dysfunction or to failure to control for age (70, 71, 73). 

Initially, frequent occurrence of amenorrhea and delayed menses among athletes was attributed to either low body weight or low body fat. In general, amenor- rheic runners weigh less, have lower weight-to-height ratios, have less body fat, and report more weight loss than other runners or nonrunner controls (26, 27, 71, 89-91). Evidence that halting training without weight gain restores normal menses suggests, however, that physical training also has an independent effect (59). Prospective studies support this hypothesis (28, 29, 92). Bullen et al. (29) monitored ovarian function before and during a 5-week intensive training pro- gram. Training provoked abnormal luteal function and anovulation in all but five of 53 observed menstrual cycles. Anovulation was most frequent in women fed a diet that ensured weight loss; however, it also oc- curred in women who maintained their pretraining weight. 

The probable hormonal pathway through which physical activity induces menstrual alterations is inhibition of gonadotropin-releasing hormone and go- nadotropin activity accompanied by a decline in serum estrogen levels (83). Cumming et al. (83) hypothesize that these hormonal alterations reflect a physiologic response to stress that, in the presence of additional risk factors, may be sufficient to affect menstrual function. Amenorrheic athletes are significantly more likely to perceive running as stressful (72) and to report higher levels of stress (89, 93). Higher mean serum (71, 94) and urinary (95) cortisol levels have also been demonstrated in amenorrheic compared with eumenorrheic runners. However, because moderate levels of aerobic activity also alter ovarian function and are less consistent with a stress model (27, 28, 92), alternative mechanisms such as negative energy bal- ance remain plausible (76, 93). Also, women who experience menstrual alterations after intense physical activity may simply be more susceptible to menstrual dysfunction. Amenorrheic athletes tend to have a later menarche and to report a history of gre?.tly variable or long menstrual cycles (72, 73, 96).

The implications of these data for women whose occupations require heavy physical labor are unclear. Rural Indian women who perform heavy agricultural work do have a longer mean cycle length than urban women (32 vs. 31 days) (24), and Nepalese women have depressed progesterone levels during seasons of increased work load when weight loss also occurs (97). 

Amenorrheic runners report consuming fewer calories, less red meat, and less fat than menstruating runners.

Exercises that evidence has shown could potentially impact on fertility include:

  • distance running
  • cycling
  • ballet

Yoga

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Yoga Inspiration 

Recognising that focusing on materialistic things is the exact opposite of the yoga mindset, I and incentivising myself with material objects.  As an incentive for regularly getting up at 5:30 am to fit in a yoga session before work, if I keep it up until the end of the year I am going to treat myself to some yoga gifts for Christmas. Some of my favourite yoga things and inspiration to keep me going: