How Stress Affect Fertility?

  • Nature's Source

It is commonly known that psychological stress is likely to affect a woman’s ability to conceive and maintain a healthy pregnancy. But what exactly is stress and how does it play such an important role in not only fertility and pregnancy, but also in overall health?

Stress Prevalence

Stress is a normal part of everyday life, and it is what allows us to have productive days. When the body is under perceived stress, your adrenal glands secrete a hormone called cortisol. Cortisol contributes to a natural rhythm in the body, helping you to wake in the morning and sleep at night. In addition, if you are in a life-threatening situation, your body should respond by secreting cortisol and preparing for the “fight or flight” response. However, in modern Western society, the body and mind are under chronic stress, causing the natural rhythm to get out of sync and leading to either an overproduction or underproduction of cortisol.

High stress is extremely common today. In a large study conducted in 2017 by the American Psychological Association called Stress in America, women aged 18 to 55 reported an average stress level of 5.1 on a scale of 1 to 10 (with 10 being the highest stress level)[i]. That was 2 points higher than what is considered healthy. About 23 percent of the surveyed women reported experiencing extreme daily stress, at levels of 8 to 10. The women acknowledged the importance of stress management, but few felt they were doing a good job of it.

Women who are struggling with their fertility generally fall within the group experiencing daily stress levels between 8 and 10. I find in practice that some women fully acknowledge the effects of stress in their lives, while others downplay its implications. Even if you don’t feel that you are stressed, implementing the following techniques will have a major positive impact on your daily life.

When stress becomes a chronic problem, it can have a negative impact on the health of your oocytes, your eggs, and your future babies. Thus, you need to become aware of the symptoms of stress. These symptoms include the following:

  • Headaches
  • Anxiety
  • Irritability
  • Low Energy (Such as Generalized Fatigue Throughout the Day or a Mid-afternoon Dip in Energy)
  • Poor Digestion (Such as Constipation or Irritable Bowel Syndrome)
  • Premenstrual Syndrome
  • Short, Long, or Irregular Menstrual Cycle
  • Heavy Periods
  • Poor Sleep Quality (Such as a Pattern of Waking Between 3 Am and 5 Am)

Abnormal Cortisol Levels

One of the ways in which high stress can impact pregnancy is through a process called “progesterone steal”. Progesterone is a precursor hormone for cortisol, a steroid hormone produced by the adrenal glands. Generally, the more cortisol your body needs to make, the less progesterone it has in reserve. If a woman has low progesterone levels, her body cannot maintain a pregnancy because either there is isn’t enough time for implantation before progesterone drops, or an early miscarriage can occur.

The high cortisol levels resulting from stress can promote inflammation in the body. Certain conditions, such as PCOS or endometriosis, can be exacerbated by higher cortisol levels. For a patient with PCOS, the higher cortisol could lead to anovulation. With endometriosis, the endometrial tissue could become increasingly engorged, leading to more pain and further abnormal tissue growth.

In office, testing can be very helpful both the Konigsberg (urine based test) as well as orthostatic blood pressure can give a general indicator as to how well the body is coping with stress.

Yet another test of adrenal function is the four-point salivary cortisol test, in which cortisol secretion is monitored at different points throughout the day. The results provide a good indication of how your body is responding to stress during the day, including whether you are over secreting or under-secreting cortisol.


Regulating Cortisol

A number of strategies are available to help regulate your cortisol level and its impact on your body. I have found the three strategies discussed here to be highly effective.

  1. For most of my patients—and for myself—exercise has been shown to be a major stress reliever. Unfortunately, exercise is often the first thing that drops out of a daily schedule when a person gets busy. It should be the last. Exercising for up to 60 minutes a day will help lower your cortisol levels. The exercise does not need to be of high intensity. It could be walking, yoga, swimming, weight training, dancing—anything that gets your body moving and that you enjoy.
  2. A consistent schedule. Your body thrives on routine. For your hormones to work most effectively, you should go to bed and get up at the same time every day. If possible, you should also exercise and eat around the same time each day. When your body “knows” consistently what to expect, the adrenal glands can start to cycle cortisol properly again.
  3. Diaphragm breathing or yoga breathing. When you engage the diaphragm for breathing, this muscle between your stomach and lungs takes your nervous system from its stressed mode to its relaxed mode. If these three strategies are not enough to restore adrenal function, there are also supplements and botanicals that could be helpful. In particular, vitamin B5 and botanicals called adaptogens (such as holy basil, ginseng, and licorice) can help to restore the healthy function of the adrenal system. For more advice regarding supplementation and cortisol regulation, you should consult your naturopathic doctor.