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I talked with a female friend about how to lose her small fat tummy. I suggested to her that she do sit-ups every day. She read in a book that doing sit-ups is harmful to women, because they may have some bad effect on the uterus and possibly cause infertility.

Is there any scientific basis for what she claims about sit-ups?

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Just a comment on your reason for suggesting sit-ups: they will probably not work to spot reduce. Generally, only losing weight overall will help with reducing the amount fat she has in that area or any area, and sometimes an area one wants is "the last to go". –  Chelonian May 22 '12 at 12:31
    
Although this wont answer your question, but I feel I sugest you try crunches as opposed to sit ups as you will a stronger burn with far less effort on your abs. There was a point in time when I first started working out I was only able to do about 50 sit ups, and then a few days later tried crunches instead and I could not get passed 20. –  Usedtobefat May 23 '12 at 18:10
    
@Chelonian I agree with you. especially the fat face is the most difficult area to reduce. –  Teifi May 24 '12 at 2:01
    
@Calvin what's the difference between crunches and sit-ups? –  Teifi May 24 '12 at 2:04
    
The sit up does not only work on your abs it also works on the hip flexors where as the crunches work the abs only.livestrong.com/article/441343-situps-vs-crunches Now this article does not state that crunches are more effective it only describes the differences. There is an article that I once read that says crunches are also more effective, but I cant find that one at this time. From my own experience tho I can say for sure that at least for me sit ups never burned quite like the crunches. –  Usedtobefat May 24 '12 at 5:18
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3 Answers

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The History of Keeping Women from Exercising

A friend of mine was told she couldn't train judo because it would somehow harm her reproductive organs. (At no time was she asked whether this mattered to her.) We know that even as recently as the 1970s, women were barred from marathons on similar grounds:

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I'm sure many physicians trained in that era are still spouting the same horseshit. Exercise-induced infertility is one of the oldest anti-woman canards in the history of misogyny. Alarm bells should go off when we hear it.

Does it Hold Water?

How many scaremongering news stories do you hear about male infertility caused by judo, or sit-ups, or football? Practically none, despite the fact that the testes are much more exposed to external injury and are damaged by overheating. Likewise, how many stories of infertility (or uterine prolapse) do you hear among the women who lift weights, run marathons, do step aerobics, play judo, or CrossFit? How many incidents are reported nationwide each year? Millions of women train hard. We would be seeing an epidemic if these activities carried significant risks.

Another answer claims that sit-ups cause uterine prolapse, which is a serious condition. The idea is that sit-ups increase intra-abdominal pressure, pushing the uterus down into the vagina. What is left unmentioned is the degree to which this is a risk factor compared to the other causes: "aging, time-related weakening of the ligaments holding the uterus up; having had vaginal deliveries; and a drop-off in estrogen production".

What else causes intra-abdominal pressure? A vast array of common activities, not just hard exercise. Something as everyday as taking a poop is sufficient. The article warns against sit-ups for this woman--not all women--because she recently experienced a uterine prolapse. This does not contraindicate sit-ups for women. That's just plain put-the-woman-back-in-the-kitchen scaremongering BS.

Similarly, the idea that sit-ups cause infertility strikes me as silly. They're not a particularly rough exercise. Are women's ovaries really that weak? I think not.

In contrast, we do see that extensive exercise can, for some women, in some circumstances, cause irregularities in menstrual cycles. (It should be noted that not exercising will of course have negative effects as well.) A brief PubMed search resulted in nothing suggesting that sit-ups are particularly harmful towards women's health.

Sit-ups are dumb anyway

The reason to avoid sit-ups is not for any of these anti-woman tropes, nor nonexistent dangers. It's because the exercise itself just isn't too great. Sit-ups are not that efficient at training the abs, and they can put stress on the lower back.

More importantly, spot reduction is a myth, so it won't help reduce belly fat any more than squats or bicycling would.

Your friend shouldn't do sit-ups, but she shouldn't do them because she's too busy lifting heavy weights, running, or boxing, not because they constitute some danger to her frail womanly nature.

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This strikes me as ranty. Sure, there is a history of poor sports advice for women, but on the other hand there are differences in female anatomy and sit-ups do interact with those differences in some cases. Is this to say sit-ups must be ruled out for all women? No. But should all women ignore this concern? No. It's just applying knowledge as warranted, right? –  Chelonian Sep 28 '12 at 19:50
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It is proudly ranty. This question should be viewed in the context of relevant history and modern views towards women participating in athletics (which are not as egalitarian as some may believe). As for your concerns, I ask you to answer my questions about relative risks and actual rates of prolapse in the vast millions of exercising, sit-upping women. –  Dave Liepmann Sep 28 '12 at 20:04
    
(Chelonian's updated answer has a link that does have some numbers, though not conclusive ones.) –  Dave Liepmann Sep 29 '12 at 6:05
    
@Berin Loritsch, @Chelonian, thanks you all, especially thanks for @DaveLiepmann. It does help a lot. Exercises is necessary, but must find a right way. Excessive exercises doesn't give any benefits to anyone. –  Teifi Nov 27 '12 at 8:25
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Apparently sit-ups (and other exercises that create pressure in the lower body) can cause problems with the pelvic floor, including promoting pelvic floor weakening, with the most extreme form of that being uterus prolapse, where the uterus is pushed down into the vagina. However, from what I've found, this is not a concern for all women, but specifically for women who already have a weak pelvic floor due to either recent pregnancy, a genetic predisposition, or other factors such as certain childbirth events.

To quote one article:

"lifting a heavy weight increases pressure inside the abdomen, which in turn pushes down on to the pelvic floor. Sit-ups, curl-ups and double leg lifts, traditionally recommended as abdominal strengthening exercises, also raise internal abdominal pressure....If the pelvic floor isn't strong and co-ordinated enough to quickly lift and hold to counter this internal pressure during exercise, then pelvic organ prolapse, or misalignment, is promoted."

This article also describes some pelvic floor strengthening exercises to help counteract this issue, which is important to note, since it seems to provide a way to do sit-ups more safely if you are doing these compensatory exercises.

Another article, specifically in the case of a 60 year old woman with a uterine prolapse, mentioned:

Things that contribute to uterine prolapse — a dropping down of the uterus into the vagina — are aging, time-related weakening of the ligaments holding the uterus up; having had vaginal deliveries; and a drop-off in estrogen production...Activities that increase intra-abdominal pressure can make the uterus fall farther. Sit-ups increase intra-abdominal pressure, as does straining to eliminate stool. You can do other exercises for weight loss: walking, jogging, biking, swimming.

So, perhaps the take-home here is that, sit-ups are not necessarily harmful provided they are done properly and the appropriate pelvic floor strengthening exercises are done along with them. If one has a particular condition such as mentioned above, one might want to consult one's physician about it before undertaking a regimen with sit-ups.

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I read the articles what you cite.it seems that doing sit-ups is terrible. how about the younger one who haven't have any child yet and do sit-ups not so severe? –  Teifi May 24 '12 at 3:04
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I can't get to the first article due to paywall, and the second article isn't for women in general, it's for a 60-year-old WHO HAS ALREADY HAD A UTERINE PROLAPSE. I think that without further evidence this answer is unnecessary scaremongering. –  Dave Liepmann Sep 28 '12 at 16:08
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I just read the 2nd article. I don't doubt that its sound medical advice for its intended audience (as Dave Lieppann mentions). It also recommends against straining to poop, for the same reasons... this really seems like advice targeted at someone with a specific pre-existing injury, not general fitness advice. –  DavidR Sep 28 '12 at 18:34
    
@DaveLiepmann, not sure how this is scaremongering when I indicated that this concern is one for those who have a weak pelvic floor--which some women have. I also include mention that there are ways to strengthen the pelvic floor to avoid this concern. If I were a woman wanting to do sit-ups, I wouldn't take this as scaring me as much as "forewarned is forearmed". And isn't that what this site is intended to do? To provide information to make an informed decision? –  Chelonian Sep 28 '12 at 19:53
    
@DavidR The 2nd article is intended for such a person, yes. But in the interest of thoroughness, and because a weak pelvic floor or related problems like prolapse are caused by entirely common female life circumstances, such as aging or pregnancy, isn't it worth at least providing this information on the page amongst other answers? –  Chelonian Sep 28 '12 at 19:54
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I've read about exercise inducing amenorrhea.

...exercise-induced amenorrhea is a temporary condition that occurs when the energy demands of strenuous exercise cause your body to go into "starvation mode" and shut down unnecessary functions, including ovulation, to keep your basic life functions going.

Another resource suggests that exercise in otherwise sedentary people will increase your fertility, as long as it isn't taken too far. Too far is defined when you have:

  • sleep disturbances
  • prolonged soreness
  • chronic muscle soreness
  • missed menstrual cycles
  • an elevated resting heart rate

Yet another resource suggests that sit-ups are safe into early pregnancy, but due to blood vessel constriction not in the second or third trimesters.

In fact the only resource I could find that would support your friend's concern was someone who was asking a similar question due to information from their acupuncturist. In other words, the association is from holistic sources, and not from traditional medical sources.

The conclusion

Exercise is important, and can improve fertility in both men and women. There are several types of exercise, and the frequency and intensity of your exercise has more influence on your fertility than any single exercise.

If your friend is not currently trying to have a child, any potential mal-effect of sit ups would only be temporary and gone in a couple days from ceasing that activity. If your friend is currently trying, but not successfully, take a look at a host of things, not just sit-ups:

  • Level of stress (including stressing about not conceiving)
  • Diet--the same thing that causes exercise induced emennorrhea will affect if your friend has too low a body fat percentage
  • Level of exercise--too much or too little. Getting those endorphins going will help with stress levels.

Anything more than that, and your friend might need to see a fertility specialist.

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This answer mostly does not appear directly address the OP's concern, which I take to be the physiological concern of creating lower abdominal pressure which, in certain cases, can promote a prolapsed uterus, incontinence, or related problems, as mentioned in the first article I cited (that woman had had a child one year prior). –  Chelonian May 22 '12 at 2:50
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It didn't address the OP's concern because I couldn't find anything to directly support it. –  Berin Loritsch May 22 '12 at 12:20
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