While being underweight can impact your ability to get pregnant, knowing what to do may empower you to feel more in control when trying to conceive. It’s best to be aware of hormones, over exercise, dieting, and disordered eating if you are smaller and having difficulty trying to conceive. Here’s a breakdown of these common obstacles and what you can do about them:
Hormonal imbalance occurs when your body is missing or has too much of one or more hormones, this leads to a ripple effect of hormone level changes and can cause dysfunction of the body’s systems such as the menstrual cycle. If you are experiencing hormonal imbalance, you may notice that your cycles are irregular or that you stop ovulating altogether. This might look like not having your period for months or years (amenorrhea), which is something that needs medical attention and shouldn’t go untreated. Thankfully, there is treatment available and once you identify exactly what’s going on, you can find the best option for you.
One potential cause of amenorrhea or loss of a regular menstrual cycle is over exercise. When following an intense exercise regimen, balanced and adequate nutrition is a must as is adequate rest and recovery. Your body is smart — when you’re overexercising or getting inadequate nutrition, your hormones shift to preserve necessary body functions and pause unnecessary processes like ovulation and menstruation. This is called functional hypothalamic amenorrhea (FHA). It is a serious condition that not only stops your menstrual cycle and ovulation, but also can lead to osteoporosis and heart disease later in life.
It is important to work closely with your provider and in some cases, a registered dietician to help increase your body’s estrogen levels and return to a regular menstrual cycle. This may mean increasing your caloric intake, decreasing the frequency and/or intensity of your exercise, and may include therapies like cognitive behavioral therapy to help cope with the mental shift associated with making such lifestyle changes.
Dieting for weight loss is a very common intervention. Most of us have been on one or more diets in our lives and while the touted benefits are lower body weight and better health, neither is found to be the long term outcome in scientific studies. In fact, 97% of people who diet regain the weight they lost and in many cases, even more within 5 years of starting their diet. When TTC, making sure your body is getting the nutrients it needs is of utmost importance. Restricting calories and cutting out entire food groups is detrimental and unnecessary. If you’re looking to nourish your body and create a healthy relationship with food, try out intuitive eating. This strategy taps into your body’s intelligence and depends upon mindfulness with food and noticing which foods agree with your body and which don’t. In general, focusing on getting plenty of fresh fruits and vegetables, protein, and whole-grain carbohydrates can boost nutrition as you prepare for pregnancy.
If you’re struggling with disordered eating, please know this is not your fault. The first step is to find a provider you trust who can recommend a mental health professional for you to meet with — they can help you determine the best treatment plan for you. Your treatment plan may include therapy, nutrition education, and/or medication among other options.
Resources that can help
- National Eating Disorders Association (NEDA)
- Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.)
Remember, even though these obstacles can be difficult to confront, you don’t have to do it alone. You can always talk to a doctor. Support groups, care teams, and loved ones are also excellent resources. Also, we are here to remind you that none of this is your fault, nor does it determine your worth or your “right” to have a baby.
Reviewed by the Ovia Health Clinical Team
- “5 Things You Need to Know About Exercise-Induced Amenorrhea.” USC Fertility. USC Fertility. https://uscfertility.org/5-things-need-know-exercise-induced-amenorrhea/.
- Pauli, Samuel A, and Sarah L Berga. “Athletic amenorrhea: energy deficit or psychogenic challenge?.” Annals of the New York Academy of Sciences vol. 1205 (2010): 33-8. doi:10.1111/j.1749-6632.2010.05663.x