Written by Stine Fremming, Specialist in Gynecology Volvat Medical Center Oslo, Department of National Theater and Majorstuen.
Women and training
It is great that so many women of all ages play sports, but being a woman can present some challenges sometimes that men get away with. The abdomen does not always play on teams. The hormones fluctuate and can cause premenstrual disorders and send the daily form to the bottom. Bleeding is inconvenient when you want to train or compete, and urine leakage is not least a problem for many women of all ages. Among female top athletes, the proportion with leakage is as high as 41%! Women who exercise also become pregnant, then the challenge is to adapt the exercise in this phase, but for a health benefit it is for mother and child with physical activity during pregnancy!
Bleeding
Fortunately, there is a lot to do with troublesome bleeding. Birth control pills are often the first choice, depending on age and other factors. They can be used as "long-cycle", eg three boards at a time. Different birth control pills work a little differently and have a slightly different hormone content, some can be used up to the age of 45. Hormone IUD removes the bleeding almost completely and is well tolerated. There is a "mini spiral", Jaydesse, which can be used by those who have not been pregnant. Birth control pills and IUDs help with PMS and various menstrual cramps, especially pain. Those who exercise a lot also need more iron. If you constantly lose blood, it can be difficult to maintain a good hemoglobin level and iron stores. Then you become lax and lack initiative, and physical performance falls of course. It is therefore not stupid to seek help if you have troublesome periods!
Note osteoporosis!
Athletic women have irregular periods to a greater extent than others as ovulation is delayed or prevented in response to sports-triggered stress. In particular, the secretion of stress hormones at low weight increases. Low fat content affects the hormones that control ovulation. Thus, estrogen values can be low at the same time as some people experience losing their period. This may be practical, but note bone mass! This is NOT good for the skeleton. Lack of menstruation is a sign that the body is not functioning properly and should always be taken seriously! 225,000 Norwegian women are brittle. The risk of being among them increases drastically if you exercise so much and hard and become so thin that you lose your period, the risk is of course greatest if you have an eating disorder as well. In general, physical activity is good for the skeleton, it maintains good bone density! After menopause, physical activity can delay the natural breakdown of bone mass, but prevent bone loss does not seem to be possible. Estrogen that we give for hot flashes can prevent the breakdown of bone tissue, but other medicines are better if osteoporosis is detected.
Do not embarrass with leakage!
Leakage of urine is awkward, it inhibits development and many people find it embarrassing. So-called stress incontinence occurs when the sphincter muscles of the bladder are weakened and the muscles are unable to prevent urine from flowing when the pressure in the abdomen increases. The reasons are several. Many of us typically experience leakage when we sneeze, cough, run and jump. The incidence is greatest after birth, but as many as 10-15% who have not given birth are also affected. Pelvic floor exercises if done correctly can stop the leakage in most people after 3-6 months of exercise. Physiotherapist Ingeborg Hoff Brækken at NIH has done a good study on this where the strength of the muscles was measured with a pressure gauge. It was found after 6 months that it increased by 44% in those who exercised. It is much! Many people use the wrong muscles, thighs and buttocks, or push out instead of lifting. Pelvic floor muscles have in common with other muscles that in order to be strong, you need hard training! If you manage to stop the jet at the end of urination, you use the right muscles. It is NOT embarrassing to ask for advice and help. We are more than happy to help! The problem is widespread and much can be done. Gynecologists and physiotherapists work closely together on this and at Volvat. Here you can map the strength and function of measurements during contraction of the pelvic floor muscles. If you do not reach the goal of exercise, you must not give up, surgery is also a successful solution for many.
Positive effects of exercise in pregnant women
Pregnancy is a special challenge when you are used to exercising a lot. The training feels heavier, the goal should definitely be nothing more than maintaining the shape, listen to the body! Running can become more difficult as the center of gravity shifts and you become more swaying in the back. The risk of back pain increases. Natural drop in hemoglobin due to increased blood volume results in reduced performance. In an uncomplicated pregnancy, the risk of fetal harm as a result of the mother exercising is unlikely. Studies of athletes who train relatively hard indicate little risk. But a prerequisite is sufficient nutritional intake. It may be okay to drop the heart rate monitor, the most important thing is that you feel good, stop as soon as you do not. Max aerobic or anaerobic exercise is not recommended. It can increase the risk of miscarriage. Be careful not to overheat, exercise with low intensity in heat and high humidity !! Drink extra plenty. It is recommended to avoid contact sports after the first trimester. When the body feels heavy and large, it is wise to switch to more gentle sports such as swimming, cycling and walking (preferably with poles). Exercise of the back and pelvic floor with strength exercises is very wise throughout the pregnancy. In general, it is very good to exercise when you are pregnant, both for mother and child! Training the first 20 weeks reduces e.g. the chance of preeclampsia with 35% and gestational diabetes with at least 50%! Exercise during pregnancy provides easier births with a shorter pressure time, fewer deliveries with forceps, suction cup and caesarean section. Apgar scores in children are higher, this is a measure of how well the children tolerated the birth. It is thought that it may have a stimulating effect for the baby to be exposed to short-term reduced bleeding of the placenta during exercise, it may make the baby better equipped for stress during birth. Pregnant women who exercise often get a better body image and self-esteem and feel better. Fewer people become depressed, exercise is known to be good for mental health! And the woman recovers faster after giving birth when she is well trained. Unfortunately, many people are a little anxious about exercising when they are pregnant, and it's a shame when you look at all the positive moderate exercise contributes!
Stine Fremming, Specialist in Gynecology Volvat Medisinske Senter Oslo avd. Nationaltheatret og Majorstuen
