Your Health is Important When Trying to Conceive

Every aspect of your health – from the drinks you consume to the exercise you do (or don’t do) – can have an impact on your fertility and on the health of your pregnancy. By looking at your healthy (and unhealthy) habits now (before the bun is in the oven) you can start off on the right foot. Our expert OB/GYN team has shared some important steps to take to ensure your health is at its best for conception, which will hopefully make conception easier and your pregnancy safer.

Habits to Break

Smoking is never good for you, so just don’t do it. But if you need a little motivation not to light up, repeat this fact to yourself: smoking (cigarettes, e-cigarettes, hookahs, vape pens, and so on) causes my 30-year-old eggs to act more like 40-year-old eggs. This results in a more difficult path to conception and a greater risk of miscarriage. Heavy smoking damages the ovaries as well as the uterus, and secondhand smoke can harm your health and fertility, too, so just choose to stay away!

Along with smoking cigarettes, smoking marijuana isn’t good for conception either. Whether you smoke, vape, or consume edibles, you can inadvertently affect the ability of your partner’s sperm to fertilize an egg – even if he doesn’t smoke marijuana! The active ingredient in marijuana, THC, gets in your vaginal fluids and reproductive organs. So to be most fertile (not to mention safe), say goodbye to marijuana. (And you should obviously also not use any illicit drugs, including cocaine, crack, or heroin, etc.).

Some studies have linked too much caffeine consumption with lowered fertility and an increased risk of miscarriage. If a baby is in your immediate plans, it’s time to put a little less coffee in your cup. You don’t have to give it up completely but moderation is the key here. Limit your caffeine intake to no more than 200 mg per day. That’s equivalent to 12 ounces of brewed coffee per day.

Another beverage to limit (or eliminate completely) is alcohol. Drinking alcoholic beverages in excess can mess with your menstrual cycle, possibly interfering with ovulation. And because you won’t necessarily know the moment you conceive, there’s a chance you might be drinking in the first few weeks of your baby’s growth. Drinking alcohol while pregnant could harm your little one in the future. Choose to reduce your drinking to less than 7 drinks a week and never more than one on any occasion when trying to get pregnant. Only you and your bartender need to know you’re drinking a mocktail.

As far as medications go, most over-the-counter and many prescription meds are considered safe while you’re trying to conceive. But because some medications may compromise fertility, you should run any medications you take by your provider before you consume them. This includes the medications you take for your chronic condition and any vitamins or herbals you may take on a regular basis. The good news is there are almost always safer alternatives. Just ask your healthcare provider before making any changes to your medication routine.

Habits to Keep

There is a strong connection between weight and fertility. Reaching a healthy weight for your body type is an important step for conception. It’s not just the scale that determines this, though. The relationship between your weight and height are factored to determine your body mass index, or BMI. Being overweight can cause diminished egg quality, decreased ovarian function, or polycystic ovarian syndrome (PCOS), a fairly common cause of fertility issues. Alternatively, women with a low BMI can also experience conception woes. Being underweight can lower estrogen levels, which can lead to irregular ovulation or periods (or even no ovulation or periods). Women who are obese or underweight when they become pregnant also have a higher risk of miscarriage.

Though it may be different for everyone, a moderate exercise program is the key. Moderate exercise can boost fertility, and you only need 30 minutes of aerobic exercise to do this. It can be walking, stretching, strength training, or anything that increases your heart rate. Remember to keep an eye on your body fat though. Prolonged, strenuous exercise can disrupt the delicate balance of hormones needed for ovulation and conception, especially if your BMI is very low. An ideal BMI for conceiving is between 18.5 and 24.9.

Before you put yourself on a diet or start packing on the carbs, it’s important to talk to your healthcare provider. Come up with a simple plan that features a well-balanced diet. Fill your meals with lean protein, veggies and fruits, and low-fat dairy. Cut down on junk foods and sugary drinks. Try water instead. Add in that moderate workout routine discussed above and you’ll be ready to kick-off your healthy path to pregnancy!

A good night’s rest is also very important. Six to nine hours of sleep per night is best. Beating the stress of the day and letting your body recuperate will only encourage fertility.

Finally, take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning a pregnancy or are currently pregnant. You can take a vitamin or eat a breakfast cereal containing your daily quota of folic acid. This will lower your risk of some birth defects of the brain and spine, including Spina bifida. Talk with your doctor about your folic acid needs. Some doctors prescribe prenatal vitamins that contain higher amounts of folic acid.


Whether it’s your first, second, or fifth baby, your body needs to be nurtured and cared for so that it can do the same for your future child. Both the female AND the male partner’s fertility can benefit from the advice listed above. And remember that no two bodies are exactly the same, so talk to your doctor before getting pregnant. They will discuss your medical history, any medical conditions you have, any medications you are currently taking, and any vaccinations you might need. This will help make a preconception health plan that is best for you.

For more information on preconception health, check out this conception plan template from the CDC.


The Obstetrics/Gynecology & Infertility Team at Medical Associates Clinic:
Joseph Berger, MD  |  Tara L. Holste, DO  |  Lisa A. Kramer, MD
Trupti S. Mehta, MD  |  Laura Neal, MD  |  Erika O’Donnell, MD

Call 563-584-4435 to schedule an appointment.


Men Need Pelvic Health, Too.

Sorry to break it to you, gentlemen, but pelvic health isn’t just important for women. You have a group of muscles at the bottom of your pelvis that helps support the organs of your urinary, GI, and reproductive systems, too. There are 14 muscles, several joints, ligaments, and nerves making up the pelvic floor. No matter your gender, the pelvic floor works to control the bladder, bowel, and sexual functions. And just like women, men experience issues when the pelvic floor muscles are tight, weak, or spastic.

The pelvic floor is a part of your inner core, which is used during daily tasks, workouts, and hobbies. Your pelvic floor can become affected after surgery, due to other injury/trauma, or due to lifestyle factors or disease processes. When this happens, men can experience symptoms such as urinary or fecal leakage, constipation, abdominal/pelvic/rectal/penile pain, erectile dysfunction, and prostatitis-like symptoms. (Please note, this is not an all-inclusive list.) Additionally, men may benefit from pelvic floor physical therapy before or after prostatectomy and following hernia repairs or other abdominal/pelvic surgeries. Up to 2 million men in the United States alone meet the diagnostic definition of persistent pelvic pain.1 And that’s just one of the symptoms that may stem from pelvic floor muscles that are too tight, weak, or those that have restrictions present in or around the tissue.

Many of the interventions that pelvic floor physical therapists use to strengthen these muscles can be applied to treatment of both men and women. Your provider should begin with an evaluation process to get a clearer picture of what is happening with the muscles, their strength, coordination, endurance, and tension. This may involve an internal (rectal) and external examination to better determine how your pelvic floor is contributing to your experienced symptoms. Please don’t let the thought of internal examination deter you. There may be other options to begin addressing your symptoms until you learn more and are more comfortable. Just be open and honest with your therapist.

So, men, speak up! If you are experiencing leakage, pain, constipation, urinary urgency, changes in sexual function, or are post-surgery for the pelvic or abdominal region, ask your doctor or call with questions. If you and your physician have ruled out other diagnoses or infections, pelvic health physical therapy may be a great option for you. Know that you are not alone in the symptoms you experience. Improve your quality of life with pelvic health physical therapy at Medical Associates.


Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic





  1. Prendergast SA, Rummer EH. Pelvic pain explained: what everyone needs to know. Lanham: Rowman & Littlefield; 2016.


What is a Kegel? Are they right for you?

Your pelvic floor muscles act as a hammock at the bottom of your pelvis that supports all your abdominal and pelvic organs. Strengthening these muscles can help with problems such as urinary leakage, fecal leakage, prolapse, general weakness, pressure, pain, post-partum pain, or instability. Many physicians or therapists, friends or family members may recommend Kegels as an intervention to address your symptoms, but what are Kegels and are they right for you?

First, let’s define a Kegel. A Kegel is an isolated contraction of the pelvic floor muscles. This means that those pelvic floor muscles are the only muscles contracting in your body (lifting up towards your head and squeezing around). No other muscles come to aid in this isolated contraction. It should be a “secret” squeeze; in other words, no one else would know you are flexing them.

But when you reach for your grocery bag, move that heavy couch, lift the baby, have a bowel movement, or even sneeze – the pelvic floor doesn’t work alone. Yes, you do need to be able to isolate these muscles to help build their strength, but it needs to work together with the inner core. This allows you to anticipate movement, respond, and create a support system for stability to decrease the strain or workload to one individual group of muscles. All the muscles of the inner core need to be balanced in strength to appropriately perform actions such as these.

Kegels do have their place in Pelvic Floor therapies, however every patient is different and not everyone should do Kegels. For example, sometimes the pelvic floor is tense or in spasm, meaning the muscles are already engaged or in a contracted position. Another type of intervention or home program may be more appropriate in this case. If tension is the source of the symptoms being experienced, those muscles likely need to be lengthened and taught to relax instead. This is why it is critical to be evaluated by someone who is specifically trained in pelvic floor therapies. Knowledge of how your pelvic floor presentation relates to your symptoms and the ability to assess what the rest of the system is doing are crucial.

If you’ve tried Kegels and they haven’t helped, please contact us. There might be modifications we can make, different muscles to address, or an altogether new therapy tactic to try. Call 563.584.4465 to schedule an appointment or ask your doctor for a referral to pelvic floor physical therapy. You can also fill out our intake form here and someone from our office will reach out to you.

Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic

Myth Busters: Pelvic Floor Therapy

Physical therapists can treat symptoms involving my bladder, bowels, or sexual function? True! Many have been doing this for several years. As this area of practice continues to advance, more providers are recognizing physical therapy as an effective and conservative treatment intervention for these diagnoses. However, every patient is different and everyone has a different experience. So with so much information available on healthcare, especially online, how do you know what is correct? Medical Associates Clinic physical therapist Britt Gosse, DPT, shares her experience and training below to help you sort the facts from the myths.

“Physical therapists can’t do anything to address this.”
Physical therapists are experts in treating the musculoskeletal system. There are 14 muscles, several joints, ligaments, and nerves making up the pelvic floor.  Not all physical therapists are trained in treatment of the pelvic floor, but there are some who have completed further training to become experts in this specific type of therapy.

“I’ve already done kegels, physical therapy can’t help me.”
Physical therapy can help. Many kegel programs can be beneficial but not for all symptoms. Additionally, a balance of muscles that engage for activities is required. Finding someone who can assess all your symptoms and the balance of your body will give you the optimal outcome.

“Only women who have had a baby go to pelvic floor physical therapy.”
Yes, post-partum women are a group that commonly benefit from pelvic floor PT, but everyone has a pelvic floor. Therefore anyone could have symptoms of pelvic floor dysfunction and benefit from pelvic floor physical therapy.

“I had surgery on my (ex. bladder, uterus, etc.) for these symptoms and it didn’t help, so physical therapy won’t either.”
Sometimes surgery isn’t the answer or it’s not the whole solution to the underlying issue that is creating your symptoms. Physical therapy may be a great non-invasive option for you as well. Discuss this with your doctor and physical therapist. Even after surgery you can benefit!

“I don’t have any pelvic floor symptoms but I just had surgery on my (abdomen, bladder, uterus, bowel, etc.).”
Even if you are not experiencing symptoms, a result of surgical procedures is scar tissue. Scar tissue can restrict normal tissue function and impair daily activities. Maybe not now, but possibly in the future you might exhibit symptoms. Being proactive with therapies to strengthen your pelvic floor muscles is a great idea for preventive health.

“My diagnosis is related to genetics. Physical therapy won’t address that.”
If this is the case, physical therapy likely won’t change the driver of your symptoms but it CAN help you manage the secondary issues occurring because of your symptoms, such as urinary urgency, constipation, abdominal pain, pelvic pain, pain with intercourse, etc. You can learn new strategies and ways to help you manage symptoms you experience.

“Other people I know said they leak when they workout. It must be normal.”
It is not normal to leak when you lift, run, jump, sneeze, sit…the list goes on. Leaking may be common but it is not normal. You can learn new recruitment strategies, balance your muscular system, and optimize overall function by working with a skilled physical therapist.

“I just had a baby; isn’t leaking or prolapse normal?”
Again, I want to stress that while these are common symptoms for many women, it is not normal. Just because something is common does not mean you have to live with it. Pelvic floor physical therapy can help you.

“I have the separation of the abdominal muscles. They said I’d have to avoid core work forever.”
This separation occurs as a natural part of pregnancy but it can create symptoms following delivery, such as feelings of instability, abdominal pain, low back pain, pelvic pain, urinary leakage/urgency. You may not have to avoid the exercises or activities you love. Many women benefit from learning recruitment strategies to protect the core, optimize function, and not create further symptoms.

“I already went to pelvic floor physical therapy and it didn’t work.”
Therapists treating the pelvic floor are all trained differently. They may have a different focus, see a different number of patients per week, or have a different type of experience or approach. Seeing another therapist just gives your symptoms another set of eyes. Research and consider a new therapist that specializes in pelvic floor therapies. Be open to your therapist and be honest about your previous experience. They will use their expertise and knowledge to address your needs with a new approach.

If you are experiencing symptoms of pelvic floor dysfunction, you may be a candidate for pelvic floor physical therapy. Contact your primary care provider and receive an appointment referral or contact the Physical Therapy Department at Medical Associates directly at 563-584-4465. For more information or to submit an electronic inquiry, follow this link.


Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic