Symposium: Diet, nutrition and exercise in reproduction
Physical activity and its effects on reproduction

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Abstract

The reproductive system is tightly coupled with energy balance, and thereby changes in the status of energy balance through changes in physical activity can impact on the reproductive system. In light of the new physical activity for health recommendations, it is therefore important to understand the inherent effects, both positive and negative, of physical activity on the reproductive system. At both extremes of the energy spectrum, disorders of chronic energy excess and energy deficiency are characterized by a wide range of reproductive disorders, including menstrual irregularity, anovulation, polycystic ovarian syndrome, and infertility in women, and erectile dysfunction and altered spermatogenesis in men. Although laboratory research indicates that individuals may be able to prevent or reverse reproductive disruptions, either by increasing energy expenditure in cases of energy excess or by dietary reform in cases of energy deficits, there is an acute need for applied research to confirm this idea and to identify mechanisms by which the availability of energy per se regulates reproductive function in humans.

Section snippets

Dr Leanne Redman is a senior post-doctoral fellow in the Health and Performance Enhancement division at the Pennington Biomedical Research Centre. She is the recipient of a Neil Hamilton-Fairley clinical training fellowship from the NH & MRC in Australia and holds a joint appointment with Centre for Reproductive Health at the University of Adelaide, Australia. Her research is focused on studies of energy balance and physical activity on reproductive health in women.

References (90)

  • J Myers et al.

    Fitness versus physical activity patterns in predicting mortality in men

    American Journal of Medicine

    (2004)
  • R Pasquali et al.

    Role of changes in dietary habits in polycystic ovary syndrome

    Reproductive BioMedicine Online

    (2004)
  • F Pettersson et al.

    Epidemiology of secondary amenorrhea. I. Incidence and prevalence rates

    American Journal of Obstetrics and Gynecology

    (1973)
  • DW Polson et al.

    Induction of ovulation with clomiphene citrate in women with polycystic ovary syndrome: the difference between responders and nonresponders

    Fertility and Sterility

    (1989)
  • JW Rich-Edwards et al.

    Adolescent body mass index and infertility caused by ovulatory disorder

    American Journal of Obstetrics and Gynecology

    (1994)
  • A Rickenlund et al.

    Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance

    Fertility and Sterility

    (2003)
  • AC Roberts et al.

    Overtraining affects male reproductive status

    Fertility and Sterility

    (1993)
  • RC Rosen et al.

    The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction

    Urology

    (1997)
  • CF Sanborn et al.

    Is athletic amenorrhea specific to runners?

    American Journal of Obstetrics and Gynecology

    (1982)
  • JE Schneider

    Energy balance and reproduction

    Physiology and Behavior

    (2004)
  • KB Singh

    Menstrual disorders in college students

    American Journal of Obstetrics and Gynecology

    (1981)
  • ZM van der Spuy et al.

    The pathogenesis of infertility and early pregnancy loss in polycystic ovary syndrome

    Best Practice in Research Clinical Obstetrics and Gynaecology

    (2004)
  • GN Wade et al.

    Metabolic fuels and reproduction in female mammals

    Neuroscience and Biobehavior Reviews

    (1992)
  • CG Bacon et al.

    Sexual function in men older than 50 years of age: results from the health professionals follow-up study

    Annals of Internal Medicine

    (2003)
  • ER Baker et al.

    Relationship of exercise to semen parameters and fertility success of artificial insemination of donors

    Fertility and Sterility

    (1984)
  • AH Balen et al.

    Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients

    Human Reproduction

    (1995)
  • KA Beals et al.

    Disorders of the female athlete triad among collegiate athletes

    International Journal Sport, Nutrition, Exercise and Metabolism

    (2002)
  • SP Bjercke et al.

    Impact of insulin resistance on pregnancy complications and outcome in women with polycystic ovary syndrome

    Gynecology and Obstetric Investigation

    (2002)
  • FH Bronson et al.

    The energetic regulation of ovulation: a realistic role for body fat

    Biology of Reproduction

    (1991)
  • BA Bullen et al.

    Induction of menstrual disorders by strenuous exercise in untrained women

    New England Journal of Medicine

    (1985)
  • M Burrows et al.

    Physiological factors associated with low bone mineral density in female endurance runners

    British Journal of Sports Medicine

    (2003)
  • EE Calle et al.

    Adiposity and physical activity as predictors of mortality

    New England Journal of Medicine

    (2005)
  • S Carroll et al.

    What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome

    Sports Medicine

    (2004)
  • AM Clark et al.

    Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment

    Human Reproduction

    (1998)
  • AM Clark et al.

    Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women

    Human Reproduction

    (1995)
  • NW Constantini et al.

    Menstrual dysfunction in swimmers: a distinct entity

    Journal of Clinical Endocrinology and Metabolism

    (1995)
  • PG Crosignani et al.

    Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet

    Human Reproduction

    (2003)
  • E Dahlgren et al.

    Polycystic ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study of women

    Acta Obstetrica Gynecology Scandinavia

    (1992)
  • E Dal Grande et al.

    Obesity in South Australian adults–prevalence, projections and generational assessment over 13 years

    Australia and New Zealand Journal of Public Health

    (2005)
  • MJ De Souza et al.

    Gonadal hormones and semen quality in male runners. A volume threshold effect of endurance training

    International Journal of Sports Medicine

    (1994)
  • Department of Health and Human Services and Department of Agriculture

    Dietary Guidelines for Americans

    (2005)
  • K Esposito et al.

    Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial

    Journal of the American Medical Association

    (2004)
  • CM Farquhar et al.

    The prevalence of polycystic ovaries on ultrasound scanning in a population of randomly selected women

    Australia and New Zealand Journal of Obstetrics and Gynaecology

    (1994)
  • KM Flegal et al.

    Overweight and obesity in the United States: prevalence and trends, 1960–1994

    International Journal of Obesity and Related Metabolic Disorders

    (1998)
  • JP Foreyt et al.

    Obesity: a never-ending cycle?

    International Journal of Fertility and Womens Medicine

    (1998)
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    Dr Leanne Redman is a senior post-doctoral fellow in the Health and Performance Enhancement division at the Pennington Biomedical Research Centre. She is the recipient of a Neil Hamilton-Fairley clinical training fellowship from the NH & MRC in Australia and holds a joint appointment with Centre for Reproductive Health at the University of Adelaide, Australia. Her research is focused on studies of energy balance and physical activity on reproductive health in women.

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