The balance of motherhood, family planning and a pro career

Armstrong with her son.

It’s a common sight in men’s cycling: the top finishers take their respective places on the podium, receive their congratulatory kisses, handshakes and flowers. They then scoop their kids into their arms and pose for pictures. It’s endearing to see them involve their families, but it’s a sight you rarely see on women’s podiums.

This is, of course, due to the very different challenge many female athletes face as they are deciding when and how to start a family.

Endurance athletes rely on a top physique to do their jobs. Often, their bodies are so lean and so devoid of body fat that the hormonal cycle is disrupted. Many endurance athletes don’t get periods anymore and upon retiring or taking a break it can still take months for female endurance athletes to get back on a regular menstrual cycle. This in turn can make getting pregnant a lengthy process. And then there is the nine months of pregnancy, plus recovery time to take into account.

For those wanting a child of their own, starting a family requires a year-long break at the least, and retirement for most.

That makes this decision of if and when to start a family a big one, and one that a large number of the women’s peloton grapples with. We talked to several riders as well as a fertility expert to learn more about balancing a professional athletic career with a family.

Simon Gerrans and his kids after the stage 1 TTT at this year’s Giro d’Italia.

Longterm planning: career first, family second

While signing on for another year with Wiggle-High5 in 2018, French time trial champion Audrey Cordon-Ragot admits that at 28 years of age, questions of when to start a family are crossing her mind.

“I’m not that old in cycling yet, I consider myself more ‘middle-aged’, but I do start to think about what I want to do after my career and when that will be,” Cordon-Ragot told Ella CyclingTips.

“I studied real estate and was an agent for three years before turning pro full-time, so I’m not worried about that part of my retirement. It’s a different question when it comes to starting a family.”

Cordon-Ragot has been married for three years and is a step-mother to her husband’s nine-year-old. In terms of having another child, she said she feels no pressure from her husband, but children are definitely in their future.

“I love babies,” Cordon-Ragot exclaimed. “I’m really crazy about babies, and I see all my close friends becoming parents now. I always realised that I had a different life and I knew I couldn’t compare my life to that of others, that I had to create my own life path. But babies melt my heart!”

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And so, Cordon-Ragot sat down and made a longterm plan. Career first, babies second, she decided. Nine years into her professional career, she’s got one more big target.

“I would like to go for my third Olympics,” she said. “And then retire after that to start a family.”

A family has also been at the forefront of Katrin Garfoot’s mind. But unlike Cordon-Ragot, the 36-year-old Australian road and time trial champion is not considering retirement.

“I want both,” Garfoot said. “[Having a baby] is one of the plans after the Commonwealth Games — to start a family and then come back for Tokyo,” Garfoot told Ella. “I know both are possible.”

| Related: Katrin Garfoot not choosing between a baby and Olympics: ‘I want both’

The struggles to get pregnant

But even the most meticulous plans can’t guarantee fertility.

Athletic or exercise-induced amenorrhea (the absence of menstruation) is well-documented among female endurance athletes and can cause infertility, something the now retired Belgian ride Lieselot Decroix learned the hard way.

Decroix ended her professional career in 2016 with the intent of getting her body back to normal in order to have a baby. The process, however, was lengthy.

 

Lieselot Decroix (Lotto-Soudal) chooses the gutter as Lisa Brennauer (Velocio-SRAM) rides the cobbles in the 2015 Omloop het Nieuwsblad.

“I never menstruated naturally, because I was a cyclist from a young age. So I started taking the pill when I was 20 years old, to stimulate some sort of menstrual cycle,” Decroix explained.

 

“I stopped taking birth control two years ago, when we decided we wanted to have a baby. But my menstruation didn’t come back for a while.”

At 29, Decroix had her first ever natural period, which most females get at the pubescent age of 12 or 13. After that, the body functioned as it should, and the former Olympian gave birth to her first child this past September.

“The combination of my career as a professional athlete, and having to juggle that with my PhD in Sport Science, meant I was asking too much of my body to be able to get pregnant,” she said. “Once I gained a little bit of weight and I reduced my stress levels, my body was coping much better.”

In her latest installment, the SHEcret Pro revealed that Decroix’ experience is far from uncommon.

“The problem with being super lean as a female elite athlete means that most of us don’t actually get our period anymore,” she said. “In fact, I don’t know when I last had my period. And probably for most of the female peloton, they won’t know either. It’s just part of being an endurance athlete, and we all talk about it —how awesome it is, how we don’t have to worry about it ever suddenly being “that time of the month” at a race — but deep down we all know it can’t really be good for us.

“We all presume it will all return to normal upon retiring, but the truth is, a lot of ex-professional athletes struggle to get pregnant after retirement,” she said. “And if you think about it, it’s not a surprise.

“We push our body to the limit, put it under intense stress with training and racing, have extremely low fat percentage, and tend to weigh well below the normal weight range for our height,” she explained. “And we do this to our bodies year after year after year.”

Exercise is good, overdoing it isn’t

For the average athletic woman, however, exercise is actually a good thing, said Dr. Baeyens, a gynaecologist at Brugmann University Hospital in Brussels who’s considered somewhat of an authority on athlete fertility.

“There are no scientific studies with professional cyclists specifically, but several studies with endurance athletes have shown that exercise is actually good for a woman’s fertility,” he said.

“On the other hand, exercising too much and having a very low body fat percentage decreases fertility. There’s a balance somewhere in between that offers the optimal fertility for a woman.”

Dr. Baeyens clarified that it is not the physical activity in itself that causes disruptions to the menstrual cycle, but rather insufficient nutrition, high energy expenditure and low body fat percentage.

Elite athletes are constantly trying to be as lean as possible. More often than not, they are consuming fewer calories than they are burning. As a result, the body doesn’t have the energy to complete a menstrual cycle, which causes a hormonal stress response and halts ovulation.

“It’s not so much about how thin someone is either,” Dr. Baeyens clarified. “Someone who’s very thin, but has a healthy body fat percentage, is physically no different from the average woman. It’s only when metabolic needs aren’t met via proper nutrition, or in other words: when someone uses more energy than what they take in, when problems arise. As soon as the body fat percentage is up to healthy levels again, conceiving should no longer be a problem.”

A healthy menstrual cycle also relies on a balanced amount of the hormones oestrogen, testosterone, and progesterone. While low body fat decreases oestrogen levels, Dr. Baeyens also noted that women who have made their way to the top level of sport have often been found to have naturally higher testosterone level, which affects fertility also and is often remedied with oestrogen pills.

“When all possible causes for the difficulty in getting pregnant have been examined and treated, and there is still no improvement, then medication must be taken to stimulate the ovaries,” he said. “We’re seeing no difference in the effect of this medication between athletes and non-athletes.”

Cyclocross racer and physical therapist Kari Studley stayed fit and healthy while carrying precious cargo.

Painful labour for athletes is a myth

Not all athletes have difficulty in getting pregnant. Hagens Berman-Supermint’s Scotti Lechuga fell pregnant without even planning to. Laura Kenny (then still called by her maiden name, Trott) conceived just a couple of months after her stellar performance at the Rio Olympics. And in her Ella CyclingTips blog, Chloe McConville revealed that she discovered she was pregnant, just months after retirement, when she noticed she was super tired. Fertility definitely isn’t a struggle for all endurance athletes.

Related: The next chapter: Professional cyclists to pregnant proprietor

Once an athlete is pregnant, there isn’t any difference in the course of the pregnancy or at child-birth, compared to non-athletes.

“Let me also disprove the myth that cyclists have such strong pelvic floor muscles, due to the many hours spent in the saddle, that it would make child-birth more difficult or painful,” said Dr. Baeyens. “That’s simply nonsense, nothing’s true of that.”

“It is rather the other way around; because athletes have better neuromuscular control, they have more control over the use of their muscles during labour,” he added.

In fact, exercise is now also being recommended during pregnancy. Even when someone didn’t yet exercise before the pregnancy, they are encouraged to take up some form of activity.

“The guidelines have changed for that,” said Dr. Baeyens. “Previously, pregnant women were advised not to exercise too much. Only if a woman was already active before her pregnancy, she could continue at a moderate level. The International Federation of Gynecology and Obstretics adjusted the guidelines after scientific research proved that exercise turned out to have a positive effect on the pregnancy and even could go so far as preventing miscarriages.”

We’re seeing more and more baby bumps on the bike, so we were already getting used to seeing pregnant women exercise. It’s a healthy development that Dr. Baeyens is happy to see.