Do extreme athletes compromise their fertility?

More and more athletes are opening up about fertility struggles, which begs the question: does elite athletic conditioning put your fertility at risk?

Unfortunately, research shows that yes, intense physical activity can take a toll on the reproductive system.

This problem is most common among women athletes in their reproductive prime. Take the case of Sarah Joyce: a competitive long-distance runner in her twenties, she was able to run over sixty miles a week. She had run two marathons and weighed in at 85 pounds. However, when she tried to get pregnant, her body failed her.

Joyce was diagnosed with a condition called hypothalamic amenorrhea, in which her periods had stopped because her body was no longer producing estrogen. This condition occurs due to dysfunction of the hypothalamus, an endocrine gland which controls the pituitary gland in the brain that signals hormone production from the ovaries. With intense training schedules and limits on caloric intake, women are vulnerable to the female athlete triad: disordered eating, amenorrhea, and osteoporosis. Most of the problems are a consequence of low body fat or low BMI.

For most women, light exercise before and during pregnancy is healthy can help lead to a successful childbirth. Low and moderate exercise can increase their chances of conception by increasing blood flow to the pelvic region and decreasing stress levels. There are no one-size-fits-all guidelines over what constitutes too much exercise when it comes to fertility since each woman’s particular circumstances (BMI, body fat percentage, and diet) needs to be taken into account. However, low BMI and low body fat put women at increased risk for having irregular or absent periods (a condition called amenorrhea).  BMI, however, provides an incomplete picture of what’s going on in a woman’s body, especially in a very fit woman’s body, and her ability to conceive. That’s because BMI doesn’t factor in the breakdown between muscle and fat. So, while an extremely fit athlete may have a normal BMI due to large amounts of muscle, she may actually have too little body fat.

More recently however, complications with fertility in men have also been associated with intense exercise. We certainly recommend that men stay active and exercise regularly, but researchers have found that pushing yourself to extreme limits can be detrimental.

In a recent study, it was found that some endurance trained athletes were more likely to have a low sperm count, decreased motility and several morphological changes that compromise their fertility.

Extreme exercise can affect male fertility in many ways, including increasing testicular temperature, causing erectile dysfunction, creating hormonal imbalances, or enabling a series of small testicular microtraumas that negatively impact the mechanical pathways of the male reproductive system. Head trauma has also been shown to affect the reproductive system by disrupting the hormones that communicate with the testes.

The good news, though, is that it the negative alterations to the reproductive system due to extreme conditioning have been observed to improve upon the cessation of high impact exercise, in many cases leading to a full recovery of the reproductive system.

All in all, working out? Good. Maintaining a healthy BMI and prolonging the health of your cardiovascular system will do wonders for your body and your reproductive system. Check with your doctor if you’re worried that you’re taking it too far, but in the end, trust your body. No one knows you better than you know yourself.

References

Arce, JC. “Exercise and Male Factor Infertility.” Sports Medicine, vol. 15, no. 3, Mar. 1993, pp. 146–169.

Du Plessis, Stefan. “Is There a Link between Exercise and Male Factor Infertility?†.” The Open Reproductive Science Journal, vol. 3, 2011, pp. 105–113.

“Is Intense Sport Making You Infertile? CCRM NoVA Physician Weighs In.” Colorado Center for Reproductive Medicine, 8 Dec. 2017.

James, Susan Donaldson. “Female Athletes Are Too Fit To Get Pregnant.” ABC News, ABC News Network, 2 Sept. 2010.

Tep, Ratha. “Can You Be Too Fit to Conceive?” Furthermore from Equinox, 5 Dec. 2017.