Movement, Prenatal Movement

The Importance of Exercise in the Preconception Period

By Georgia Hartmann
Naturopath, Nutritionist & Women’s Health Expert

When it comes to optimising fertility and preparing for pregnancy, there are numerous factors that must be considered一alcohol, caffeine, sugar and trans fat consumption, sleep quality, stress management, nutrient status, underlying health conditions, smoking, exposure to endocrine-disrupting chemicals, weight, the list goes on…

One factor that we can all start prioritising today is regular exercise. Not only is exercise beneficial for reducing the risk of 40 chronic health conditions including type 2 diabetes, cardiovascular disease, and cancer, but it is also incredibly beneficial in balancing hormones.[1-2]

Here’s an insight into exactly how.

Exercise helps to balance hormones associated with excess weight
It is well known that carrying excess weight increases the risk of infertility and miscarriage. We also know that moderate exercise influences IVF outcomes. A recent meta-analysis found a 1.96-fold increase in clinical pregnancy rate and 1.94-fold increase in live birth rate in physically active women compared with physically inactive women. The effect is due to the positive influence of exercise on insulin sensitization and ovarian function. Influencing levels of insulin is incredibly important in those carrying excess weight as this hormone is commonly elevated. [3-4]

Exercise helps to balance hormones associated with high stress
Elevated, uncontrolled stress is associated with infertility, cycle irregularities, poor sperm quality, and miscarriage risk. It can be challenging to find time to exercise when you are feeling stressed and overwhelmed. However, this is the perfect time to do so. What we know about stress is that it is associated with increased production of cortisol, one of our stress hormones. Research consistently shows us that regular exercise reduces cortisol levels. And if you have exercised prior to entering a stressful situation, your cortisol levels are much lower─ meaning you are able to cope with stress more. A recent study of almost 400,000 individuals also found that those who had a physically active lifestyle had around 60% lower risk of developing anxiety─again, through the positive impact of exercise on our stress hormones. [5-7]

Exercise helps to balance hormones associated with poor sleep
Sleep not only affects hormonal balance, but also sperm function and IVF outcomes. While approximately 30% of the general population experience sleep troubles, a readily-available, non-pharmacological therapy without side effects is regular exercise. Recent randomized controlled trials have confirmed that exercise reduces insomnia severity, and improves ability to fall asleep, stay asleep, and overall sleep quality. From a fertility standpoint, we know that both female and male fertility, as well as IVF outcomes may be affected by short sleep duration and shift/night work schedules. In order to have adequate levels of our sleep-promoting hormone, melatonin, exercise is best performed in the morning rather than afternoon or evening.[8-10]

Exercise helps to balance hormones associated with reproductive conditions
Regular exercise is increasingly being recommended to manage a range of chronic health conditions including painful periods and endometriosis. While some research suggests exercise can exacerbate painful symptoms in women with endometriosis, a recent study assessing endometriosis self-management strategies during the COVID-19 pandemic reported that exercise undoubtedly has an overall positive impact on well-being.[11]

In the case of polycystic ovary syndrome (PCOS), which is a leading cause of fertility difficulties among reproductive-aged women, exercise has shown beneficial effects on lipid profiles, waist circumference, blood pressure and fasting insulin. It has also been shown to balance hormones, particularly androgens and oestrogens. [12-14]

So, if you are considering conceiving, now is the time to prioritise regular exercise.

References:

[1] Ruegsegger, G.N., et al.

Health Benefits of Exercise. Cold Spring Harbour Perspectives in Medicine, 2018. 8(7). PMID: 28507196.
[2] Ennour-Idrissi, K., et al. Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast Cancer Research, 2015. PMID: 26541144.
[3] Harrison, C.L., et al. The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health. Seminars in Reproductive Medicine, 2016. 34(2). PMID: 27169984.
[4] Rao, M., et al. Maternal physical activity before IVF/ICSI cycles improves clinical pregnancy rate and live birth rate: a systematic review and meta-analysis. Reproductive Biology and Endocrinology, 2018. 16(1). PMID: 29415732.
[5] Khaled, K., et al. Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis. Nutrition Journal, 2020. PMID: 32859204.
[6] Wood, C.J., et al. Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress. Anxiety, Stress and Coping, 2018. 31(2). PMID: 29037088.
[7] Svensson, M., et al. Physical Activity Is Associated With Lower Long-Term Incidence of Anxiety in a Population-Based, Large-Scale Study. Frontiers in Psychiatry, 2021. PMID: 34566716.

[8] Caetano, G., et al. Impact of sleep on female and male reproductive functions: a systematic review. Fertility & Sterility, 2021. 115(3). PMID: 33054981.
[9]
 Banno, M., et al. Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ, 2018. PMID: 30018855.
[10] Carlson, L.A., et al .Influence of Exercise Time of Day on Salivary Melatonin Responses. International Journal of Sports Physiology and Performance, 2019. 14(3). PMID: 30160559.
[11] Leonardi, M., et al. Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic. Human Reproduction Open, 2020. PMID: 32509977.
[12] Benham, J.L., et al. Role of exercise training in polycystic ovary syndrome: a systematic review and meta-analysis. Clinical Obesity, 2018. PMID: 29896935.

[13] Shele, G., et al. A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome. Journal of Functional Morphology and Kinesiology, 2020. 5(2). PMID: 33467251.
[14]
 Smith, A.J., et al. The Effects of Aerobic Exercise on Estrogen Metabolism in Healthy Premenopausal Women. Cancer Epidemiology, Biomarkers & Prevention, 2013. 22(5). PMID: 23652373.

About the author:
Having been diagnosed with Premature Ovarian Failure two years prior to conceiving her first child naturally, Georgia’s passion lies within helping women overcome their hormonal imbalances through the blend of conventional and complementary medicine. For additional support, you can contact Georgia via:

IG: georgiahartmann_naturopath

W: www.georgiahartmann.com

E: hello@georgiahartmann.com

Prenatal Movement

Pilates For Prenatal Mums

Congratulations, you’re expecting a baby! There’s no secret your body is about to go through some pretty impressive (and slightly weird) changes. You’re creating a human inside of you and while you’re busy doing everything possible to help your little one thrive, it’s important to look after yourself as your body grows too.

Throughout each trimester your body will continue to change structurally and as your bump gets bigger and bigger your centre of gravity will shift. Your pelvis will also tilt, giving you an increased curve in the lower spine, your head and neck will be at the mercy of your ever-changing boobs, you’ll notice an increase in ligament laxity and you’re chances of succumbing to flatter feet and hyperextended knees also increases. There’s a lot going on, but remember this is different for everyone.

It goes without saying, Pilates is the most effective form of exercise for pre- and post-natal clients. Sure, it’s a great way to safely (key!) maintain your fitness, but it also places a heavy focus on good posture, abdominal strength and pelvic floor strength.

But that’s not all… any good Pilates instructor worth their weight in pre-natal knowledge will also be mindful of targeting the areas that soon-to-be-mummas will desperately need once bub is born. We’re talking, strengthening your glutes, quads and arms — because you’ll need them to lift, carry and nurse — and stretching, by working on opening through the chest and lengthening through your obliques. With all of that in mind, any thoughtfully prescribed program should help to keep you feeling energised throughout your pregnancy and help to reduce any niggles that might present themselves the closer you get to giving birth.

What you need to know about Pilates and your first trimester

  • Expect to feel tired and nauseous 
  • At this point you might notice a release of relaxin that can cause laxity in your joints
  • You can undertake Pilates as normal, but if you find lying face down uncomfortable — don’t do it! — tell your instructor

What you need to know about Pilates and your second trimester

  • Do not undertake any exercises that require you to be lying face down
  • Your instructor will program more squats and leg and footwork exercises during this trimester
  • Your centre of gravity will undergo more changes
  • Any abdominal exercises will be reduced in intensity

What you need to know about Pilates and your third trimester

  • Things are about to get a little more uncomfortable as your body gets bigger
  • Of course, you can’t do any exercises that require you to be face down — your instructor will know this — and getting up and down off the floor will be a challenge
  • You’ll find you will fatigue faster
  • Your Posture will continue to be compromised
  • Ensure your heart is positioned higher than the baby’s when exercising, this means avoid lying on your back for extended periods

The abdominal focus will shift to your pelvic floor — something that will come in handy when the time comes