My current fertility practice is based in the mountains of Boulder, Colorado. Even though I saw patients for 15 years right outside of NYC, where exercise was a pretty “standard” part of my patients’ daily life, I’ve never seen exercise like I see exercise in Boulder. I have patients who are marathoners; not just 26.2 mile marathons, but 100 mile marathons!! Overnight running! It’s a thing, I guess. Tri-athletes, rock-climbers, ecstatic dancers, Buti Yoginis, Cross-Fitters, extreme skiing, etc. Everyone here seems to exercise to the max.
How exercise can impact your reproductive health
While I do encourage all of my patients to move their bodies regularly, when hard-core working out is such a big component of a woman’s life, it’s important to really understand how it might be impacting her reproductive health, including her fertility.
I should start by saying that I believe that body movement (this wording seems to be less triggering for many than "exercise," which comes with a lot of stories) needs to be part of a healthy lifestyle.
We need to feel and move our body, not only for cardiovascular health, bone density and muscular strength, but also to feel embodied, to connect with ourselves as human bodies on the earth. This might sound obvious or even weird to some, but it’s important to mention, especially since so many of the women with whom I work are extremely spiritually-focused, or heavy into meditation. These women often view their body as a nuisance, something they just have to deal with that might be preventing them from being fully spiritual beings. They often speak of a desire to bypass their body. Menstrual cramping or physical pain feels like a burden they wish to ignore, a reminder of the limitation of their physical body.
On the other end of the spectrum, there are the avid runners, the marathoners, the high-intensity workout enthusiasts who strive to push their body as far as it will go. I often see these women because of injuries they have sustained as a result of this intense exercise — rotator cuff issues, knee pain, back injury, foot pain and often total-body depletion and exhaustion. For these women, their body is also a reminder of their limitation, not in that it prevents them from totally experiencing the spiritual, but in that it can’t always sustain the pushing, the striving for more.
Few of the women with whom I’ve worked are able to fully experience and feel their body as it is… NOW, in the moment. For this reason, I recommend body movement that encourages not overly strenuous pushing, but rather being and feeling into the body. This is not to say that it shouldn’t be challenging or hard, but there should always be a focus on breath, on awareness of the body, in terms of both its mechanics as well as the energy moving within. Yoga, pilates,Lagree method, barre, NIA and intuitive dancing are excellent choices.
Know your “cortisol” level
It’s also important to note that while cardiovascular exercise is important, our bodies have not necessarily caught up, in terms of evolution, with how we exercise. Running, for instance, stimulates your body’s fight or flight response. Your body can’t necessarily tell the difference between, say, running away from a mountain lion (I'm in Colorado, so this is a real and regular thought when I'm out late) and trying to work off last night’s piece of chocolate cake. Either way, your body will release cortisol, a stress hormone that, when out of balance, can shut down your body’s less critical functions like reproduction and immunity.
While this blast of cortisol was necessary for cavemen, who needed their body to release energy to focus on immediate physical threats (ie. that mountain lion), our stress levels today are far more constant and psychological. Many of us feel stressed All. The. Time. Our cortisol levels are already elevated and out of sync with our natural rhythms. When cortisol is too high for too long, it can have serious negative effects, including suppression of the sex hormones that are necessary for fertility and reproductive health.
It is my strong belief that so many women’s hormones are so completely out of balance because of this over-release of cortisol. Our body simply cannot focus on “unnecessary” functions like reproduction when we are constantly trying to keep up with functioning amidst the inundating stressors of daily life.
I encourage all of my fertility patients to choose body movement that gets their heart rates pumping a bit, like brisk walks and hiking instead of running or kick-boxing. This is often met with huge resistance. I know that runners love running. I get that it feels like it’s a form of therapy. I get the oxytocin release. I get that it feels good (I mean, I don't actually "get it" because, to me, it feels AWFUL, but... )I get that distance running is a way to shut off your mind. I get that it can feel like the only way to reduce your stress level.
But I’m not doing my job if I don’t tell you that running can negatively impact your fertility. If you absolutely cannot stop running, it’s imperative to add practices that can reduce stress as well as the release of cortisol. This includes meditation, yin and restorative yoga, embodied, intuitive dance, etc.
Exercise can be a big part of our identity
My teachers back in acupuncture school would remind me of a common belief of many Chinese traditions, that we are born with a certain number of breaths. There’s a strong focus on living life in a way that helps to conserve these breaths, to lengthen our breaths. This is why practices such as Qi Gong and Tai Qi are such a big part of those cultures. They focus on moving the body in a way that is in sync with intentional breathing.
I understand that for many women, the way we exercise can feel like a big part of our identity. It can be tied up with so much more than just how we move our body. It is often wrapped up with our sense of our strength, our power, how we feel in our own skin. I completely understand my patients’ attachments to particular forms of exercise. But my request to you, if you’re trying to get pregnant, is to begin to bring an awareness to your womb as you exercise. Ask your womb what it needs to feel nurtured, nourished, supported. This is the energy your womb needs to conceive, to be able to nurture, nourish and support a life within. Begin by asking… and then do your best to trust and honor the answer.