Exercising too much could affect fertility in young, healthy women, expert warns – ABC News

Kylie Johnson was the ultimate picture of health when she first started trying for a baby in her late 20s.

The banking-sector worker from Sydney's south, who spent her spare time tackling gruelling ultramarathons, was young, fit, and healthy all the key ingredients she was told were needed to become pregnant.

But her two-and-a-half-year road to conception made her question everything she thought she knew.

"Every time you left the doctor's surgery, you felt kind of deflated [thinking], 'what's wrong with me?' And why isn't this happening?" she explained.

"I'm doing everything that they're telling me to do."

And Kylie's story is hardly unusual infertility affects one in six Australian couples of reproductive age.

So, why would young, healthy women who keep their body in peak physical shape struggle to conceive?

Well, it's complicated.

Developing a greater understanding of your own hormonal changes could help you identify when you're optimised to tackle tasks and set goals.

Infertility means you're unable to get pregnant after 12 months of trying naturally (or six months for a woman over the age of 35), and there are so many reasons why it may not happen for both men and women.

Unfortunately for some women who love to exercise (a lot), there are unique risks.

Whether someone's a gym junkie, a weekend warrior, or an elite athlete, a clue to their fertility can be found in their periods.

Former Australian Diamonds netballer Susan Pettitt can relate. She struggled with infertility after retiring in 2018.

"We know regular periods are going to help you with [conceiving]. But when you're playing, that's not your top priority," she said.

"[I thought] it will happen when I'm finished netball, because I knew that netball was such a small window that I didn't want to miss any opportunities."

After 18 months of trying and a series of inconclusive tests, Susan and her husband Brad underwent IVF treatment.

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They were successful after three cycles, with son Cooper born in July this year.

Susan is still unsure why they couldn't conceive naturally. But her experience has all the hallmarks of a relatively unknown and misunderstood health condition that can put even the most seemingly healthy women at risk of not getting pregnant.

Put simply, if you're over-exercising and not eating enough, that could lead to a loss of periods for at least three months, or irregular, heavy periods that may only appear a few times a year.

It's a pretty common but little-known condition known as athletic amenorrhoea.

Susan recalls how focused players and medical staff were about getting the best out of their performance at major events and planning their periods around that.

"We train so hard that our menstrual cycle is a lot smaller, irregular," she said.

"We don't have it monthly. We might have three or four months without it, or we might even skip them."

Kylie, on the other hand, would sometimes go up to a year without having a menstrual cycle and thought it was completely normal.

"I was just like, 'oh, that's just me, that's just my body'," she said.

The idea that a woman's period can come second to her fitness or performance seriously concerns fertility specialist Dr Natasha Andreadis.

"What perturbs me is that these women are not really freaked out by the thought of not having regular cycles of course, until the time comes when they actually need to have regular cycles to fall pregnant," the gynaecologist said.

And often, she says, it's because they're exercising too much.

"To match the exercise, they're not eating enough. So it's usually because they're not actually getting enough fuel and as a consequence are not sufficient in their fat mass, which is really important," she added.

Thankfully, there's no impact on a woman's long-term fertility once regular menstruation returns.

But amenorrhoea isn't just a concern for those who want to start a family.

It can also cause high cholesterol, premature ageing, and loss of bone density, which could lead to osteopenia or osteoporosis.

Many women don't even realise if they have menstrual irregularities or amenorrhea, as it's masked by their use of the contraceptive pill.

It's especially common amongst athletes it's estimated the pill is used by nearly 50 per cent of all elite Australian sportswomen.

Brisbane Lions players use an app requiring them to check in daily with a simple questionnaire about how they're feeling at training at a certain point in their cycle.

Dr Andreadis believes doctors often prescribe the pill too quickly to treat menstrual issues for women from all walks of life, rather than addressing the root cause.

"We can do a lot better by these women by encouraging them to harness the power of their menstrual cycles and not just treat them with hormones over time," she said.

At the professional level, Susan wants sporting organisations to take more responsibility to help protect their athletes' fertility.

"We plan everything else in our lives, but we just don't plan that part of it. We have medical examinations every year and we go through every muscle and every joint and everything about our bodies, but we just don't talk about fertility," she explained.

Really, periods are only part of the problem.

After having her own tests done, Kylie discovered she had polycystic ovarian syndrome (PCOS) a hormone issue that can affect fertility.

Paralympic swimmer Monique Murphy spent years battling an insidious enemy within her own body that consumed her with crippling pain.

While exercise is recommended to treat PCOS, Kylie was running to an extreme level regularly tackling ultramarathons of 50 kilometres or more and that was actually making matters worse.

Her high running load compared with under-fuelling was making it impossible for her body to conceive.

"I think I was malnourished. I was eating a lot, but not enough for someone that was running so far," she said.

"My nails were brittle, my hair was breaking, all the signs were there. I just I didn't want to see it because I loved what I did so much.

"And I think that's the problem where my body was kind of screaming at me and telling me what you're doing isn't healthy, but I just didn't want to hear."

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Ultimately, an ankle injury forced Kylie to curb her running.

By that point, after two and a half years of trying, she had given up on having a baby, convinced it just wasn't to be for her and her partner.

But the simple tonic of stopping her high-intensity exercise and eating more was enough for her body to recover and she unexpectedly became pregnant with son Henry, who is now 18 months old.

"It just required me to step back into self-love and self-care for him to come along," she said.

Every woman who wants to have a baby knows the pressure that comes with that biological clock ticking.

It kicks up a gear when a woman is in her early 30s as fertility starts to decline. Then it intensifies from the age of 35.

In the elite sphere, many women's sports, like netball, now have improved maternity policies to encourage athletes to start a family during their career.

Susan was 34 when she retired and says there's still the prevailing attitude to wait until your playing days are done, so you don't lose your spot in the team.

She also believes coaches are reluctant to discuss fertility and family planning with players, for fear of losing them in their prime years.

After her success with IVF, Susan also had her eggs frozen. It's something she's encouraging younger players to do so they can have it as a safety net when they're ready to start a family.

But Dr Andreadis warns it might not be the silver bullet athletes are hoping for.

"I feel that it's important that we stress to these women: there's absolutely no guarantee that if you freeze 30 or 40 mature eggs in your 20s, that you will absolutely get pregnant from that batch of eggs," she said.

"You won't know if you will be able to fall pregnant until you start trying."

The path to conceiving can be an incredibly emotional journey for so many women, and the hurdles that invariably pop up along the way look so much steeper when you feel like you're the only one facing them.

Kylie admits that in her like-minded community of female runners, they were more likely to discuss the latest sneakers on the market rather than their menstrual irregularities.

Even the medical experts she sought out weren't equipped with the proper knowledge to help her, making it an isolating, frustrating experience.

Susan agrees it's time for women to start talking more about issues like periods, fertility and miscarriages, so they can support each other rather than suffer in silence.

Despite their challenges along the way, both women know they're amongst the lucky ones.

After all, they've got Henry and Cooper to show for it.

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Exercising too much could affect fertility in young, healthy women, expert warns - ABC News

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