The Dos and Don’ts of Exercise on Fertility and Managing Endometriosis

Contrary to popular belief, exercise can boost your chances of conception whilst managing endometriosis. We know that exercise is beneficial for your general health and wellness and can help your body get ready for pregnancy. Regular exercise and maintenance of a healthy weight has been shown to improve symptoms of endometriosis, and potentially assist with fertility.

Moderate exercise, like walking, lifting weights, aerobics and swimming, have been proven to help reduce inflammation associated with endometriosis, a key cause of infertility in affected women. Regardless of how frequently the women exercised, they were found to have lower oxidative stress and inflammation in their bodies compared to those who didn’t exercise, showing the power of exercise in improving and treating endometriosis.

Let’s dig into a few Do’s and Don’ts of exercise whilst managing Endometriosis and fertility.

The Do’s

Exercise Regularly

Before you start trying to conceive, consider incorporating regular exercise into your routine. This can significantly improve your overall health, mood, and fertility. Physical activity can help regulate your menstrual cycle, making it easier to predict ovulation.

Add Variety

To be well rounded in your fitness it’s important to add in different forms of exercise whether that is swimming, strength training or Pilates.  Especially when managing Endometriosis flare-ups, you want to have a “tool-box” full of different modes of exercises. This is especially important on the days you don’t feel like you want to exercise or on a day where your regular exercise routine is too painful.

Core Strength

Now this recommendation is more to prepare your body for when you do become pregnant! Pregnancy can significantly change your body, causing your belly to grow, your breasts to enlarge, and your center of gravity to shift. These changes can put strain on your back and other parts of your body. To help prevent back pain and discomfort during and after pregnancy, it’s important to strengthen your core muscles beforehand. A strong core can also improve your balance and posture, both of which are crucial during pregnancy.

Intensity

Vigorous physical activity has been shown to be particularly effective in helping overweight and obese women improve their health and well-being. It can promote weight loss, improve cardiovascular health by strengthening the heart and lungs, and build muscle mass, which can boost metabolism. Exercise also plays a crucial role in mental well-being, releasing endorphins that can improve mood and reduce stress. Furthermore, regular physical activity can lower the risk of chronic diseases such as type 2 diabetes and certain types of cancer.

The Don’ts

Do too much too soon

If you are a regular runner or cross-fit athlete, then yes you can continue to work at those levels when trying to conceive as long as you are giving yourself enough rest time to not alter your ovulation or luteal phases in your cycle. For those managing endometriosis, it’s important to slowly introduce new forms of exercise as to not exacerbate symptoms or create a flare-up.

Contact Sports

This should be in a maybe column, do continue to play your team sport to keep your morale up and maintain your social network. The don’t is for when you do conceive as with many team sports quick movements in different directions are required and when pregnant your balance is affected and we want to avoid an injury to you and baby!

Lose lots of Weight

This will largely depend on where you are at in your fertility journey. For those that are overweight, it is best to optimise your weight prior to trying to conceive to improve your overall and reproductive health. If you are at a healthy weight, then you want to ensure you aren’t overexercising and losing weight.  Falling too far below your weight will affect your bodies ability to ovulate regularly.

IVF/Assisted Conception

Undergoing IVF can be physically and emotionally demanding. It's essential to listen to your body and prioritize self-care during this time. While exercise can be beneficial for overall health, it's important to be mindful of its intensity, especially when undergoing IVF or ICSI cycles.

Studies suggest that moderate physical activity before IVF cycles can positively impact pregnancy rates. However, once you're in the midst of an IVF cycle, it's generally recommended to avoid rigorous, high-intensity workouts.

One significant concern is the risk of ovarian torsion. This serious condition can occur when an ovary twists on its supporting ligament. The incidence of ovarian torsion has been reported to be higher during controlled ovarian hyperstimulation, which can occur but is not common during IVF treatment.

If you're undergoing IVF, it's crucial to consult with your healthcare provider about any planned physical activity. They can provide personalized advice based on your specific situation and the stage of your treatment. By striking a balance between rest and moderate exercise, you can support your overall well-being and improve your chances of a successful IVF cycle.

Every woman’s fitness routines, pregnancies and conception journeys look so different. Always speak to your healthcare provider about any concerns you might have and understand the best way to move your body.

References:

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Sitzberger C, Oberhoffer-Fritz R, Meyle K, Wagner M, Lienert N, Graupner O, Ensenauer R, Lobmaier SM and Wacker-Gußmann A (2020) Gestational Diabetes: Physical Activity Before Pregnancy and Its Influence on the Cardiovascular System. Front. Pediatr. 8:465. doi: 10.3389/fped.2020.00465

Body mass index, physical activity and fecundability in a North American preconception cohort studyMcKinnon, Craig J. et al. Fertility and Sterility, Volume 106, Issue 2, 451 - 459

Montenegro ML, Bonocher CM, Meola J, Portella RL, Ribeiro-Silva A, Brunaldi MO, Ferriani RA, Rosa-E-Silva JC. Effect of Physical Exercise on Endometriosis Experimentally Induced in Rats. Reprod Sci. 2019 Jun;26(6):785-793. doi: 10.1177/1933719118799205. Epub 2018 Sep 19. PMID: 30231769.

Bonocher CM, Montenegro ML, Rosa E Silva JC, Ferriani RA, Meola J. Endometriosis and physical exercises: a systematic review. Reprod Biol Endocrinol. 2014 Jan 6;12:4. doi: 10.1186/1477-7827-12-4. PMID: 24393293; PMCID: PMC3895811