Posts Tagged ‘fertility’
Natalie Portman & I
I’ve been struck by how much press has been devoted to Natalie Portman’s decision to give up being vegan during pregnancy. I guess the media loves a good story, but the hype on this does seem a little out of proportion.
We definitely live a world where everyone and everything is defined by sound bite adjectives. We’re all on information overload and in order to keep up we generalize, compartmentalize, and abbreviate. It’s easier to think of a “healthy lifestyle” as something defined by a set of rigid principles and apply the label to yourself (be it vegan, raw, 80/10, paleo, etc.). I realized awhile ago that I needed to get past this line of thinking, a difficult process in that it’s been my rationale for more than half my life. Is avoiding animal products better for the planet, YES! BUT, there are no gold stars awarded for living 100% vegan or raw. This is not my path to enlightenment.
But back to the Natalie Portman story… According to the articles, one reason she started eating eggs is that she craved baked goods from regular bakeries. I also went through the starchy-sweet phase for quite a long time. I had no idea how much the hormones would throw off my regular pattern of eating. The very sight of salad during my first trimester made me nauseous. To trick myself into eating veggies, I had to steam them until they were limp and then slather them in soy-free Earth Balance. For a week during our team cross country camp in Bend, my diet staple was gluten-free banana bread from Strictly Organic Coffee. I even stock-piled it to take back to Portland. I also craved whole milk yogurt, hormone-free rotisserie chicken from Zupan’s, the occassional scrambled egg and more sweet potatos than I ever thought possible to consume.
Whether it’s our bodies telling us we need iron, protein or some other nutrient combination, I think it’s best just to go with what sounds good… especially if it isn’t just fast-food and jello! Labels can wait, they will always be there in case we want to run back to them.
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Birth Control and the Female Distance Runner
Let me start by saying, of course this is a complicated issue with no black and white solution. I honestly think it will take me a number of posts to say what I would like to.
Both the pro and anti oral contraception crowds have some data to backup their claims. It’s easy to find female athletes across the spectrum: from those who are able to perform fine on the pill; to those who recognized that they couldn’t achieve their athletic potential while taking the hormones; to women who simply couldn’t function on any form of oral contraception.
The truth is that the studies are extremely limited, and the ones using actual athletes are even more so. Like many issues in women’s health, the lack of data is extremely frustrating.
Though some distance runners begin taking the pill for other reasons – such as acne, birth control, ovarian cysts, etc. – many are urged to start taking it because they are amenorrheic, meaning their menstrual cycles have stopped. There is documented evidence that women who are amenorrheic in young adulthood fail to build the optimal amount of bone and may suffer from low bone density later in life. There is even some data to suggest that a certain extent of this loss may be irreversible.
While the link between estrogen and bone density seems to be established, the logic that birth control pills will protect bone density has not been thoroughly tested. This approach to amenorrhea in young women is actually based on the treatment of post-menopausal women with low bone density using hormone replacement therapy.
There are many reasons that a woman can experience amenorrhea, and by extension thought to be low estrogen. My theory is that our bodies can only handle so much stress and that they need a certain level of homeostasis to function properly. Our stress levels are affected by our diet, activity level, emotional health, and environmental pollutants. Any combination of these assaults can contribute to a stress load that is too much for our system to function normally. When this happens the body goes into crisis mode and decides to stop menstruating.
The reality is that there are a number of highly trained, extremely lean competitive athletes who have normal menstrual cycles. There are also many non-athletic, average weight young women who are amenhorreic. Body-fat and training-level don’t necessarily tell the whole story.
One of the side effects of oral contraceptives that I find very troubling is the increased incidence of depression and mood disorders. The altered brain activity is largely contributed to interference of serotonin uptake and absorption of B-vitamins. This can be extremely detrimental for athletes and anyone suffering from disordered eating. In addition to helping the body handle and process stress, B-vitamins also play an important role in carbohydrate metabolism.
Another consideration is that the hormones in birth control pills, estrogen and progesterone, help feed the overgrowth of yeasts in the female body. Systemic yeast imbalance can result in a variety of very serious conditions including many digestive problems, food sensitivities, allergies, yeast infections, UTIs, skin conditions like acne and eczema, infertility problems, weight gain, and various other ailments.
The latest study about birth control pills reducing a women’s chance of gaining lean muscle mass is really disturbing for athletes. Running, especially, is all about strength to weight ratio.
Again, there isn’t an easy answer to the question of whether birth control pills are good for female distance runners (or athletes in general). There are a number of reasons why I think they aren’t a good idea for everyone. I don’t agree with the blanket prescription policy that is currently in place in most health institutions. Obviously birth control pills can be appropriate for some individuals, but that doesn’t mean that they should be prescribed out so quickly as the solution to every female problem.
I am not a medical doctor, but in my experience, health and athletic performance are best fostered when we look at the whole person. I also feel that a discussion of oral contraceptives in female distance runners or other athletes is incomplete without a further discussion of eating disorders, but I’ll reserve that for another post.
If you are wondering whether you should be taking the birth control pill, I urge you to weigh the positives and negatives and research the subject for yourself. Most doctors see a variety of patients, don’t specialize in treating athletes, and don’t necessarily keep up on the latest research. You have to be your own advocate. If you are you only taking the pill for birth control and are a serious athlete, it might really be worth taking the time to evaluate the trade-offs.
More later…
*A side note about Ortho Tricyclen…. My theory is that this company gives a lot free samples and kickbacks to Doctor’s offices because they always prescribe patients on this pill first. According to doctors, they start women on a tri-phasal pill (meaning three different levels of hormones) because it mimics the normal phases of the female’s cycle. The flaw in this logic, as far as I’m concerned, is that when you’re talking about girls who are amenorehic, they don’t have a cycle… so this artificial phasing is very difficult on their systems.
Link to the article about birth control pills interfering with lean muscle mass
Link to article about birth control pills and distance runners
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My Birth Control Story
I feel that my situation was pretty typical of what a number of female athletes go through. I was prescribed Ortho Tri Cyclen* when I was 17 because I hadn’t had a period for more than two years. Not wanting to put anything artificial in my body and being scared about the hormones, I didn’t actually start taking the pills until I sustained a stress fracture in my foot during my freshman cross-country season at college.
After the fracture, a doctor convinced me that it occurred because my bone density was low. He said my bones were suffering because I didn’t have periods. This was the case because the absence of menses meant that my body didn’t have enough estrogen… and estrogen was the key to calcium being absorbed by my bones. He told me that my estrogen was low because I ran so much. And he said all this could be corrected by taking the birth control pill because it would supply my body with artificial estrogen that would keep my bones strong.
The Female Athlete Triad- of disordered eating, amenorrhea, and osteoporosis- was a relatively new buzzword ten years ago and doctors, trainers, and coaches were quick to jump to the conclusion that the birth control pill was the easiest, quickest-fix band-aid solution to the most bothersome part of it. I wish that I could say that as a community, sports medicine has made tremendous progress – that doctors, coaches, and trainers know a great deal more about how to address these situations with their athletes, but I don’t really believe it’s much better. Birth control pills are more than ever being prescribed to young athletes (and non-athletes alike) as a quick-fix solution to problems that require a much deeper and more comprehensive look at the whole system.
When I look back at my own situation, I realize that the Doctor made a lot of assumptions in his hypothesis. First, he assumed that my stress fracture was due to having low bone density, though he never measured the density of my bones. In reality it was my training that changed significantly – I had gone from running maybe 40 miles per week on dirt roads in high school in Colorado to running 70+ miles per week in college mostly on pavement.
The other reality about my situation was that running or body fat percentage wasn’t the cause of my amenorrhea. I was always a very active teenager and a “late bloomer.” I played 3-4 varsity level sports during high school. I only had a couple “regular periods” when I was 15 years old and they ceased when I left to be an exchange student in southern Brazil. In Brazil I wasn’t allowed outside of the house alone. It was, by far, the most sedentary I have ever been at any time in my life. And like all exchange students, I gained a few pounds. And yet this is the time in my life when my periods stopped. When I returned from Brazil, I embarked on a 30-day wilderness education course backpacking across Colorado’s San Juan Range. But still my cycle didn’t return.
Over the years I stopped taking birth control twice for several months at time to see if my period would return on its own. Each time I noticed a marked improvement in my mood and digestion, but each time a friend or doctor encouraged me to go back on the pill because I needed it for my bones. I remained on a mono-phasal birth control pill until the age of 25. At that point, my digestive problems and allergies were so bad that I wanted to try anything to alleviate the situation. I read as much as I could find on the subject, scheduled a bone density scan that came back on the low side of normal, and quit the pill for good. It was a liberating feeling!
Eventually, about 7 months later, my cycle returned naturally for the first time in over 10 years. For the first year or two it was not consistent- some months it wouldn’t come, some months it would only last a day. However, the overall trend was one of progress.
Acupuncture has been the single most helpful tool for me in finding hormonal balance and regulating my periods. I highly recommend it!
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So Long Stevia- from VegNews.com
I was alarmed to find this article about Stevia on the Vegnews website. I eat a fair amount of stevia… ever since the non-bitter types came out a number of years ago. My favorite brand is NuNaturals out of Eugene, Oregon. It really has the cleanest flavor of any that I’ve tried over the years. The maltodextrin doesn’t seem to have any adverse affects on my stomach at all. The new Truvia, however, doesn’t sit as well. I appreciate them trying to cut stevia with Erythritol to give it that granular sugar-like quality, but my system doesn’t do well with sugar alcohol even though Erythritol is much more gentle on my system than Xylitol.
An aside: Erythritol & xylitol, are natural sugar alcohols so they are digested differently than regular sugar and don’t produce the pronounced blood-sugar spike and insulin response… too much of which is linked with diabetes and weight gain. Erythritol is known for having less gastric side effects than other sugar alcohols because it is absorbed in the small intestine while xylitol is absorbed in the large intestine and larger quanities often lead to gas, bloating and a laxative effect. Erythritol, has 5% of the calories of table sugar (.2calories per gram vs. 4 calories per gram) and 70% of the sweetness. So it is almost calorie-free 
But back to the sweet stevia leaf…. after reading this article I want to figure out how it affect fertility in women, not just men. ugh. I really don’t want to give up my little white packets. They make cocoa & tea so much more delightful.
READ THE FULL STORY ON VEG NEWS.COM
Does this sugar stand-in stymie hopes for fertility in the future? VN’s resident nutritionist studies the sweet substitute.
By Ilyse Simon
Confused about whether or not switching from sugar to stevia might hurt your chances at parenthood? Your nutritional debate is understandable. Though the Food and Drug Administration approved stevia in December, there’s still some question about how much is really safe, especially if you’re trying to conceive. The short answer is that adding stevia to a cup of tea or coffee each day won’t compromise your health. However, stevia is worth scrutinizing if you plan to use it often or in large quantities.
Stevia is a shrub native to South America with leaves sweeter than white sugar. It’s calorie-free and one of just a few alternative sweeteners for people with diabetes, and the FDA has designated stevia Generally Recognized as Safe. (This is controversial because there are many products deemed “safe” by the FDA that I would never consider consuming, and the FDA has a history of protecting big agribusiness over human health—but there’s an element of truth to this one.) Stevia has been used in other countries for centuries without ill effects. Used to sweeten yerba mate in Paraguay and in Japan to sweeten pickles since the 1970s, stevia—in small quantities—has not been proven harmful. The main concern is that if we mass-market this plant extract as we have with soy, stevia could become a ubiquitous ingredient in everyday packaged foods. If your energy bar, smoothie, tea, and dairy-free ice cream are all sweetened with stevia, that might be more than is considered healthy.
North Americans, in general, still think more equals better, and tend to go to extremes when we find something we like. Again, it’s similar to the soy story: Asian cultures eat moderate amounts of soy daily in whole-food forms without negative consequences; Western cultures have processed and refined soy into isolated protein components, added it to highly processed energy bars, and continue scarfing them down like health foods. This is where the problems lie. The specifics on stevia show that high amounts affect male reproductive health with reduced sperm counts and possible infertility. In some laboratory studies, stevia acts on a cell’s DNA to cause unwanted mutations and may promote cancer. In other studies, large amounts of stevia interfere with normal carbohydrate metabolism. Recently, the Center for Science in the Public Interest lists stevia as an additive that people should “try to avoid,” but maintains that small amounts are probably safe.
The bottom line is that a little is probably fine, but a lot is not. That’s advice for almost any situation. One or two cups of coffee with stevia is not raising concern amongst researchers. It’s the scenario where stevia sweetens diet soda, fruited waters, and every piece of chewing gum stuck to your shoe that is of concern. Keep your diet clean, eat lots of fruits and veggies, go ahead and ditch the tighty-whiteys, and your fertility will likely be fine.
