Is Stress Stealing Your Fertility?
Tough day at the office, looming deadline or worried about your finances?
All of the above can cause psychological stress, making you feel anxious or upset and in turn cause a physiological response. Yes, it's true.
We were not designed to be in a constant stressful state. The stress response is beneficial of course, in small doses but we were not designed for much more than this.
Increased stress levels, 'Hello 21st Century Living'', have been shown to deplete sex hormones and interfere with your body's natural reproductive pathway, knocking your menstrual cycles out of whack, resulting in delayed or absent periods and making it more difficult for you and your partner to conceive.
In this article we discuss the relationship between stress and fertility to understand if stress really has the power to affect fertility. It will also help you to understand what stressors we are putting on our bodies...some you may not even be aware of.
The Basics: What is Cortisol?
Cortisol, often called the "stress hormone" is a steroid hormone produced in the adrenal glands above the kidneys and is controlled by the Hypothalamic-Pituitary-Adrenal (HPA) Axis. It is a chemical messenger telling various parts of the body how to react
Although it is referred to as the stress hormone, Cortisol is so much more than just a hormone released during times of stress. It regulates metabolism, controls blood sugars, helps to reduce inflammation, controls water and salt balance as well as blood pressure.
'Fight or Flight'
What we know about Cortisol and the 'fight or flight response' is that it acts as a protective mechanism when we are in supposed danger. In cases of an imminent threat the body reacts by releasing Adrenocorticotropic Hormone (ACTH) from the brain which causes the release of adrenaline and cortisol from the adrenals. This in turn causes glucose stores to be made readily available as an energy source. This is beneficial in small doses when for example we have an important presentation at work or a job interview that needs our top attention.
Chronic stress i.e prolonged stress, in particular however, can have negative health consequences, adversely affecting so many other functions (the immune, cardiovascular, neuroendocrine, central nervous system and what we care the most about here - REPRODUCTIVE FUNCTION.
This continuous 'fight or flight' state causes a disruption in the reproductive axis as the body gives higher priority for survival over reproduction. This of course has implications for fertility.
Stress interferes with fertility in two ways. It interferes with the signalling in the brain required for normal menstruation and steals your hormones to make the stress hormone Cortisol.
Look at it like this...
We were designed to reproduce. In moments of stress, our bodies were designed to survive and in doing so, shut off the reproductive pathways.
Why would your body try to get pregnant when your being chased by a lion?? (or running marathons....it's the same thing). It's evolutionary and for a reason.
So what's changed? Lions have been replaced by work deadlines and various other stressors we can unknowingly put on our bodies. If this high level of stress continues, it can prevent ovulation, disrupt the uterine preparation for pregnancy and either delay or stop your menstrual cycle all together. This is all very well documented with many war and famine studies researching these affects on reproduction.
Have you ever had a delayed or missed period during an exam or a bereavement? There you go. That's the stress response.
Some other interesting studies have even found that even if you do become pregnant amongst all this chaos...fetal exposure (exposure to the baby in the womb) to glucocorticoids (stress) has been seen to restrict fetal growth, increase blood pressure, negatively effect kidney development and weaken heart function in offspring. All of this stress you are putting on your body can and does have negative effects and so finding a happy balance is important.
What research is there?
There has always been much debate as to whether stress alone can directly cause infertility. Data suggest that stress and reproduction are interrelated; however, the directionality of that association is unclear. Theoretically, high levels of Cortisol can interfere with normal hormonal functions and it has been called ‘The Steal’. The precursor to both cortisol (our stress hormone) and our sex hormones is the same and so if you are stressed then this precursor can be directed or 'stolen' to make more cortisol, causing our sex hormones to be depleted. If this happens consistently, it can really knock the sex hormones off balance.
'The Steal': Estrogen, Progesterone, Testosterone and Cortisol are all made up from the same building block. Chronic stress 'steals' the important building blocks needed for fertility
High cortisol also stops the secretion of the hormone that our hypothalamus sends to the pituitary (GnRH) that tells it to make LH and FSH. LH and FSH are the hormones that the pituitary makes in order to signal the ovaries to make estrogen and progesterone and so are crucial for reproduction.
Stress shuts off our menstrual cycles
One large prospective cohort study in the UK tested salivary cortisol and α-amylase levels in women (biomarkers for stress), and found that increased levels of stress were directly linked to a lower probability of pregnancy. Even if the salivary α-amylase is considered only a surrogate marker of stress and sympathetic-adrenal-medullary (SAM) axis activity, this data seems to confirm the ability of stress to exert its effect on female fertility. Other researchers find it hard to make such a direct link.
What we do know: Stress has a scientific mechanism and shouldn't be underestimated
Common stressors:
Stress is perceived differentIy by each individual but I think it can be agreed that in times of stress our behaviours can change. These changes in behaviour can really affect fertility and chances of conception. For example:
Lack of Sleep
Lack of sleep, just like stress, can elevate cortisol levels and unfortunately as per the Centre for Disease Control and Prevention (CDC) - more than 1/3 of people do not get adequate sleep. Reduced sleep interferes with your natural Circadian Rythm, aka your 'Sleep Wake Cycle' which is responsible for the LH surge required at ovulation and for sperm maturation. This can cause irregular cycles for woman and so please don't underestimate the power of at least 7 hours sleep per night.
Exercising
We love exercise and encourage a healthy lifestyle however not averyone is aware that it can have both positive and negative affects. The right amount of excercise is key. When we exercise we reap many benfits. Improved cardiovascular health, reduced risk of diabetes, depression and even cancer. Exercise as we know acts a stress reliever too, which is what we want right? So we definitely encourage exercising; but balance is key.
Over-exercising however can add a stress on the body that is linked to irreular and absent periods (Hypothalamic Amenorrhea) and difficulty conceving. Hypothalamic amenorrhea develops when poor nutrition or stress alters your signaling to the brain to regulate the menstrual cycle. Women with this condition may be severely restricting their caloric intake, exercising more than two to three hours a day, or under major psychological stress. If you are exercising a lot (training for a marathon etc.) and experiencing irregular cycles please do go and see your Gynecologist. Hypothalamic amenorrhea can be reversed but if not caught early, can often take a very long time. Even if you are not considering starting your family now, it is always best to look after yourself and your future fertility.
Emotional Eating
When we are stressed, we tend to eat unhealthier and are more likely to reach for that chocolate bar. Consistent high levels of stress have been proven to lead to weight gain, and weight gain and obesity have in turn been linked to fertility problems.
Smoking
When stressed, smokers tend to increase their nicotine intake in an attempt to relax.
Smoking in Women:
Smoking can affect fertility in women as it is associated with an increased risk of a blockage in the fallopian tubes, damage to the eggs in the ovaries, increased risk of miscarriage and and increased risk of cervical cancer.
Smoking in Men:
Smoking exposes men to high levels of cadmium and lead, metals that have been linked to decreased fertility. Studies on male smoking have also shown a decrease in the quality of semen including a 13 percent decrease in sperm motility. Smoking is also strongly correlated to an increased risk of erectile dysfunction, with some studies showing a three-fold increase in erectile dysfunction among male smokers. The more a man smokes, the more likely it is that he'll suffer from erectile dysfunction which will make it much harder for his partner to conceive.
Low Libido:
As much as sex can be a stress-reliever, a stress-filled life and hectic schedule can lower your libido, so you might not be in the 'sexy mood' as often. Of course, if you want to get pregnant, sex is an important factor and the more you have sex, the higher the chances of conception.
The General Consensus
The current general consensus among medics and researchers is that stress is not a sole cause of infertility but can trigger many contributory factors which inhibit conception as well as affecting your sex-drive. These contributory factors such as an increase in production of cortisol, unhealthy behaviours and unsound lifestyle habits can result in late, irregular or missed periods and erectile dysfunction, all of which in combination with low-libido can make conceiving more difficult for both you and your partner.
Are you going to just sit around and let stress steal your fertility?
I didn't think so... Here are some things that you can do:
Make time to relieve stress and limit these unhealthy behaviours.
Take a walk, read a book, leave work at the office, exercise and be extra mindful of your eating and drinking habits when you're stressed. Quit smoking, it is the single best thing you can do to increase your fertility potential and within your control. Quitting is no mean feat and so ask for support or get in touch and we can help you kick that habit.
Your body, hormones and fertility will definitely thank you for it.
Have further questions for us about stress? Feel free contact us. Alternatively, join us on Instagram @thefertilitytalk