What do you know about Fertility Health?

The menstrual cycle is another "vital sign".

Age when menstrual periods start and menstrual cycle variations are indicators of overall health. Length and regularity of the cycles may tell us when a young woman is developing normally and/or whom is at risk for cardiovascular disease, hormonal problems and cancers. 

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Menstrual Variability: 

Cycle length is defined as the first day of the menstrual period to the last day before the start of the next period. Many women have variation in the length of a cycle and that is entirely normal! What that means is that a range is what is usual...such as 25 days, then 30 days, then 27 days, then 32 days and so on. Women with truly irregular cycles have less than 9 cycles per year. Only about 13-15% of women actually have 28 day cycles!

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Post-hormonal contraceptive cycles:

Oral Contraceptives (the Pill): Research shows that immediately after stopping birth control pill use, almost 60% ovulate in the first cycle after stopping. The cycle length was prolonged until the 9th cycle. Cycle disturbance and insufficient post-ovulatory phases are more frequent (30% of women) until the 7th cycle. So waiting for 3 cycles to try to get pregnant is usually advisable.

Cycles after Depo-Provera: the average time to clear the drug from the body is about 6 months. The average time for the return of fertility is 9 months.

BMI -- Body Mass Index:

Body mass index influences menstrual function in healthy women. There is evidence that fertility is decreased by having a BMI > 25 kg/m2 (too heavy) or <18.5 kg/m2 (too thin. Both have longer than average cycle lengths. This may indicate disturbances in ovulation. Post-ovulation phase defects may occur (this means that there is inadequate progesterone levels) which can lead to miscarriage or pre-menstrual symptoms (PMS).

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Exercise: 

Exercise is recommended in moderation. The health benefits of exercising are well-known including improving insulin levels. Only excessive exercise resulting in a low BMI (unhealthy levels) would have a negative effect on the cycle.

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Stress: 

Acute or chronic stress is associated with variation such as shorter or longer than usual  menstrual cycles. High levels of stress significantly increased long cycles (over 43 days). The type of stress may vary depending on the woman's life situation. Stressful jobs doubled risk for short cycle length. It is possible that stress would lead to poor quality of ovulation and thus inadequacy of the post-ovulation phase.

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Smoking: 

Smoking is associated with short cycle length. The more you smoke the more likely that ovulation doesn’t occur and the phases are abnormal. The effect can last a long time. Women who smoke are 3 times more likely to experience a delay in getting pregnant. Smoking reduces the number of eggs in the ovaries and damages the cilia in the fallopian tubes (important to transport the egg to the uterus). 

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Marijuana & Alcohol:

Marijuana is very disruptive to ovulation and to the menstrual cycle. The substance in marijuana (THC) is later found in vaginal, cervical, and uterine secretions and interferes with the sperm's ability to fertilize the egg.

There are few studies that include the effect of alcohol consumption on menstrual cycle characteristics. The evidence is unclear as to exactly what level of alcohol consumption has an effect upon fertility. High consumption (> 8 drinks/week) was associated with decreased fertility.

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Sleep Habits:

Melatonin is the “sleep hormone” that is involved with a woman’s cycle. The hormone is even found in the fluid that surrounds the egg in the ovary.

Light exposure at night may have pronounced effects on the menstrual cycle and symptoms through the influence of melatonin. For example, female shift workers report more menstrual irregularity and longer cycle lengths. Women with 20+ months of rotating shift work were more likely to have irregular cycles or short cycles. However, there are other women who are more sensitive to light at night. It is a good practice to keep your bedroom as dark as possible--not only will you sleep better but it is good for your fertility as all menstrual cycles characteristics were improved but such practices in research studies.

Keep the electronics out of your bedroom. Put your cell phone on airplane mode. Turning off your router at night is also advisable. More information is emerging that demonstrates the disruptive effects of the EMFs emitted from these devices.