Stress and Fertility – is there a connection? In fact there is, and a very strong one at that. Stress can have a negative impact on your fertility and reproductive health in several ways. Stress seems like such an abstract term, and not long ago the entire medical profession underestimated its effect on our health. We now know so much about the profound effects stress can have on our physiology and reproductive health. In fact, stress is one of the leading causes of all disease. It is likely that it has a major role to play in cases of unexplained infertility and can aggravate nearly any other reproductive health diagnosis.
How Stress Hormones Can Cause Infertility
- Impairs follicle health and development. Stress reduces the secretion of estrogen from the follicle which reduces the thickness of the endometrium and the fertile mucous
- Reduces the secretion of progesterone from the corpus luteum in the luteal phase, and thus affects implantation. Stress can cause luteal phase defects
- Affects the surge of luteinizing hormone (LH) from the pituitary gland which is responsible for stimulating ovulation
- Increases prolactin secretion by the pituitary gland, which inhibits ovarian function
- Affects the part of the immune system responsible for preventing miscarriage in early pregnancy
- Negatively impacts many other health concerns which may impair fertility – such as thyroid health, autoimmune conditions, allergic conditions, PCOS, Endometriosis, and gastrointestinal concerns
Understanding What Happens in the Body During Stress
During stress, the adrenal glands which sit on top of the kidneys are stimulated to produce stress hormones including cortisol and adrenalin. This process happens due to a mechanism which begins in the brain, specifically, in the hypothalamus. Activation of the sympathetic nervous system (the flight or fight aspect of the nervous system) occurs. The hypothalamus, pituitary gland, and adrenal gland work together through feedback mechanisms to perceive stressors in the environment and produce stress hormones that enhance survival in challenging times. Though these hormones allow our bodies to successfully overcome major stresses and threats, they are often counterproductive when trying to conceive.
How Stress is Related to Early Miscarriage
It has also been more recently discovered that adequate progesterone levels are required for immune tolerance during early pregnancy. There are significant changes which occur in the immune system during early pregnancy to prevent the mother’s immune system from rejecting the newly implanted embryo.
The effect of stress on progesterone levels can interfere with this natural immune process, leading to early pregnancy loss. A 1995 study found that women who had significant work related stresses were more likely to have experience miscarriages. This was especially significant in women over 32, and in women carrying their first child. Elevated urinary cortisol (a marker of stress) has been found in several studies to be associated with a higher rate of miscarriage.
Effects of Stress on IVF & ART
A 2005 study found that women who had lower adrenaline levels at the day of retrieval and lower adrenaline levels at the day of transfer had a higher success rate in IVF cycles. A study on Swedish women undergoing IVF found that those who did not conceive had an overall higher level of stress hormones including prolactin and cortisol in the luteal phase of their cycles, indicating that stress negatively affects implantation. An Italian study in 1996 showed that women who were more vulnerable to stress had a poorer result in IVF
Naturopathic Testing to Diagnose Stress for Fertility Concerns
Our licensed Naturopathic Doctors can assess your stress levels and the degree to which they may be affecting your fertility. Some of the techniques she may use include:
- Measurement of stress through laboratory testing by blood of AM & PM cortisol, and adrenocortex stress profiles
- Urinalysis for adrenal stress hormones
- Assessing for physical signs and symptoms of stress
- Orthostatic blood pressure testing
Naturopathic Treatments for Stress
If stress is a major factor for you, naturopathic medicine can help. Supplements or herbs will be prescribed for you which are clinically proven to reduce cortisol levels, improve adrenal health, and improve your body’s resistance to stress. Acupuncture is a powerful treatment that reduces excessive secretion of stress hormones while enhancing blood flow to the ovaries and often a series is given which can have great benefits.
You will also learn body-mind techniques such as reproductive massage, deep breathing exercises, and you will receive emotional health journaling and meditation exercises to complete at home.
Our Naturopathic Doctors are experienced in working with stress related fertility concerns and we feel that this type of program is one of the most successful ways to improve your outcome. Stress is the silent partner in millions of cases of infertility worldwide and at White Lotus it is treated with the same focus and emphasis as other conditions which lead to infertility. Time and time again we have seen that working with stress is the missing piece to the puzzle for so many patients who have tried all forms of other treatments in the past. When the impact of stress is minimized, barriers to healthy conception are removed. Balance is restored to a patient’s nervous system, allowing pregnancies a chance to flourish.
References for this Article
- Arck P, Hansen PJ, Jericevic BM, Piccinni MP, Szekeres-Bartho J. Progesterone during pregnancy: endocrine-immune cross talk in mammalian species and the role of stress. Am J Reprod Immunol 2007;58:268-79.
- Csemiczky et al. The influence of stress and state anxiety on the outcome of IVF-treatment: Psychological and endocrinological assessment of Swedish women entering IVF-treatment. Acta Obstetricia et Gynecologica Scandinavica Volume 79 Issue 2: 113 – 118 Dec 2001.
- Facchinetti et al. An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization-embryo transfer treatment. Fertility and Sterility Volume 67, Issue 2, February 1997, Pages 309-314
- Magiakou MA, Mastorakos G, Webster E, Chrousos GP. The hypothalamic-pituitary-adrenal axis and the female reproductive system. Ann NY Acad Sci 1997;816:42-56.
- Nepomnaschy PA, Welch K, McConnell DS, Strassman BI, England BG. Stress and female reproductive function: a study of daily variations in cortisol, gonadotrophins, and gonadal steroids in a rural Mayan population. Am J Human Biol 2004;16:523-32.
- Smeenk et al. Stress and outcome success in IVF: the role of self-reports and endocrine variables Human Reproduction 2005 20(4):991-996
- Wagenmaker et al. Cortisol Interferes with the Estradiol-Induced Surge of Luteinizing Hormone in the Ewe. Biology of Reproduction March 1, 2009 vol. 80 no. 3 458-463.