Mahri Relin, a former NYC dancer, FlyBarre Creative Director, and Tracy Anderson instructor, has been training pregnant and postpartum women through her company Body Conceptions for a long time. When she told me about her work with exercise and fertility, I was blown away. There is little information available on the connection between fitness and fertility, but it makes total sense - a healthy body, makes a healthy home for a baby. I am excited to have been able to connect with Mahri to share more about her work in this relatively uncharted field as well as the science behind her philosophy.
If a woman is experiencing infertility, can exercise help?
Mahri: Yes, exercise can absolutely help. However, it’s important to say here that exercise needs to be done carefully and with a knowledge of current guidelines. And it should be discussed in the context of what a doctor recommends. If someone has a body fat percentage that is too low, for example, any exercise should be avoided that further decreases body fat. Even people who fall within a recommended body fat percentage range should avoid doing too much cardio or exercising too many hours per day or week. Having said this, exercise can provide a wonderful opportunity to reduce stress, help balance hormone levels, and support the body’s overall function and fertility. Consult with your doctor, and also consider using an exercise specialist who understands fertility.
How does exercise affect a woman's fertility? Tell me about the research.
Mahri: There are several different ways exercise can affect fertility that have been fairly well-researched. One of the most significant starting points relates to your BMI (or calculated relationship between your height and weight). An ideal BMI pre-pregnancy is between 20 and 25. Having a BMI greater than 30 can reduce your fertility by 50%, so incorporating a gradual weight loss program of diet and exercise can be extremely helpful. Women with a BMI below 18.5 also experience increased infertility and should avoid exercise that causes an energy deficiency and incorporate a diet that helps them gain weight properly.
BMI is not always the best indicator since it cannot distinguish between weight cause by fat or muscle mass, body fat percentage has been studied as an alternate indicator. Research suggests that ovulation can decline if body fat percentage falls below 12% or rises above 30-35%, even if you get your period every month. Again, exercise can be a great way to help regulate these factors, and they should be combined with nutritional support as well.
Although a bit less understood, factors like the type of exercise you do and how much you exercise per week seem to affect fertility as well. High levels of cardio are correlated with greater risk for adverse perinatal outcomes, and excessive exercise has been correlated with greater menstrual irregularities, although there may be other factors at play as well (like stress, diet, etc). From a larger review of research, it appears that exercising between 30 and 60 minutes per day but not more than 4 hours per week produces the best outcomes for ovulatory-factor fertility levels and successful live birth rates. It’s also beneficial for your fertility to have a history of regular exercise, even if you need to tone down the amount and intensity of this exercise during the time you are trying to conceive.
Is this topic well researched? What can we do if we don't have all of the information?
Mahri: Unfortunately - beyond some basic principles - there is very limited research on the effects of exercise on fertility, and it can also be contradictory and complex. There also appears to be pretty big individual differences in what we can tolerate and what we are used to doing, which means that something like running for one person can feel great and relaxing while it could feel extremely difficult and stressful for another person. In the absence of strong consistent research, it’s best to check with your fertility doctor first to find out what you might need as an individual. Do you need to gain or lose body fat? Is there a hormone imbalance that might be caused by your current exercise habits (e.g. too much cardio)? How does exercise make you feel? On average, following basic exercise guidelines regarding cardio levels and exercise length per day/week should be a good starting point. I personally recommend as well that you choose exercise you love. Find a teacher or trainer who makes you feel great, choose movement your body craves, and look at exercise as a great way to relieve the natural stress caused by the fertility journey.
I’ve heard you speak about using exercise to feel good, what do you mean by this?
Mahri: One of my favorite benefits of exercise is the way it makes you feel! Stress is a big contributor to infertility, and abnormal cortisol levels can suppress ovulation and also affect the balance of estrogen, progesterone, and sex hormone ratios. Staying in chronic “fight or flight” mode can also lead to the disruption of proper digestion and can contribute to sleep disruption, food allergies, and chronic fatigue.
Done correctly (without too much intensity), exercise can lower cortisol levels and also release endorphins that produce a feeling of euphoria and act as natural painkillers. Exercise can also contribute to the release of feel-good brain neurotransmitters like serotonin and dopamine. Personally, I can’t say enough about how well it has regulated my own moods.
There are so many other subtle factors in exercise that I love. Breathing correctly into all sides of your rib cage (rather than up into your shoulders) can stimulate the vagus nerve and the parasympathetic nervous system. This system is responsible for rest and relaxation, and it also slows you heart rate and regulates digestion and sexual arousal, among other functions. Spinal twists can also have the same effect.
All of these factors together help explain why people feel so great after they exercise. And to me as a dancer, moving your body is so much more than just a fitness experience. It’s all about connecting with music, expressing your feelings, connecting with others, letting off steam, owning time for yourself, and feeling stronger and more capable than before.
Should every woman engage in the same exercise program while trying to conceive?
Mahri: As I mentioned previously, there are large individual differences between women and their responses to different kinds of exercise. While one kind of activity could stress one person’s body, it might feel great to another person who has done that kind of exercise for a long time. People also have wide range of tastes in terms of what they like to do and how their body wants to move. Since one of the primary reasons to exercise is to reduce stress, it’s important to get in touch with what feels best to you. Doing what you love will encourage you to stay committed and will more likely reduce cortisol levels (as long as it’s not too intense). In general, an exercise program that combines a balance of cardio and body strength will likely have the most benefit hormonally. And doing what is most recommended for you based on your initial body fat percentage and BMI is crucial, but the specific exercise you choose that falls within these guidelines can vary. Some of my personal favorite options include barre or Pilates with some cardio and dance fitness like Body Conception’s programs that combine both cardio and body sculpting.
How could a woman listen to her body while exercising and trying to conceive?
Mahri: Being able to listen to your body is one of the most important and also most difficult things to do. In an age of “more is more,” we often don’t train ourselves to pay attention to pain or exhaustion because we are always pushing to do more. When it comes to fertility, it’s especially important to notice the signals in your body telling you that you are doing too much. Do you feel depleted at the end of a workout? Is it hard for you to sleep that night because your muscles don’t relax, even if the workout exhausted you? It’s likely that depletion, exhaustion, and sleep disruption are signals that your exercise might be too intense right now. Consider looking for exercise that leaves you feeling positive and energized and helps you sleep more soundly. And seek cardio that still allows you to be able to hold a conversation with someone — between a 5 and 8 on a 1-10 exertion scale. Anything above 8 is probably a little too intense right now. Everything is relative, so don’t look to others to decide what works for you. Start tuning in to your own body signals. They will tell you everything!
Are there other lifestyle choices that are important for fertility alongside exercise?
Mahri: Absolutely! Since stress is a major contributor to infertility, making lifestyle choices that decrease stress levels in other ways can be so helpful - like meditating, connecting more with friends, practicing gratitude, etc. Drinking and smoking (which are also connected with stress levels) can also affect fertility. Getting enough sleep is crucial, and choosing foods with dense nutrients that help control insulin and other hormones can also be so beneficial.
It’s so important for women struggling with fertility to explore all of these factors with their doctor and other holistic specialists. It’s also important for us as a culture to keep in mind that women have been historically blamed for their fertility problems, and they can feel very scrutinized for issues that may be beyond their control. It’s important to become as educated as possible on the controllable factors that affect fertility and also allow for the possibility that you haven’t done anything wrong. There may be other factors at play, including male infertility.
Have you experienced anything interesting with women trying to get pregnant for the second time in terms of exercise habits?
Mahri: That’s a really fascinating question. I find that many women tend to be less stressed the second time around, and they feel a little more confident and informed as they go through the process. On the flip side, it might be extra confusing the second time if their experience does not match their first pregnancy. They may also have stress about their body changes and want to exercise a little too intensely before their second pregnancy to “prep” their body — without realizing that too much exercise may not be helpful. Having a child already can also affect their ability to find time to exercise. Many of our clients choose in-home (or in this case virtual in-home) training because they need someone to come to them at a time that’s most convenient (e.g., during naps or school).
Clearly there are so many factors at play! For moms who want a second child, I encourage them to do what they can without stressing too much. Be kind to yourself and above all find ways to feel as good as possible in your body without letting anyone judge you. You can do it!
For more information, you can find Mahri atwww.bodyconceptions.com,@bodyconceptions or workout with here atwww.bodyconceptions.intelivideo.com(the first week is free!).