The stress-infertility connection

When I was working in fertility clinics, the most common diagnosis given was “infertility, unexplained.”  With all our diagnostic advancements, I doubt this has changed much.  Sometimes there are structural impediments to fertility or genetic conditions that require significant intervention.  In most other cases, such as ovulatory or hormonal disorders, suboptimal sperm parameters, endometriosis, and of course unexplained infertility, lifestyle changes can be the most impactful intervention.  While diet, nutrition, and exercise should be addressed from the start, one very important factor is often overlooked despite its importance - stress management. 

Stress is undeniably a huge factor in health and wellbeing, but lets get more specific about why and what is happening in our body when we are stressed, specifically in regards to fertility.  And then, lets take that next step and do something about it.  

Short term stimulation of the adrenals from stress, whether emotional or physical, results in the release of cortisol.  Cortisol is designed to help your body deal with stressful situations, but with persistent elevated cortisol, our health begins to suffer.   Over time the adrenals “burn out,” they cannot keep up, and adrenal fatigue results.

In terms of fertility, prolonged stress inhibits production of reproductive hormones, such as GnRH (gonadotropin releasing hormone), and consequently LH and FSH, important hormones that support ovulation and follicle development.  Progesterone levels are often reduced because progesterone is instead used to produce more cortisol.  Progesterone is important in supporting the uterine lining and consequently a pregnancy.  The thyroid can also be affected, leading to hypothyroidism.  These hormonal changes can lead to menstrual cycle irregularity, impaired ovulation and infertility.  This effect is not limited to women.  Stress can also affect sperm count, motility and morphology, or lead to impotence.

The good news is that we have control over our stress response and these changes are most often reversible. 

Tips for managing stress:

·      Reduce the amount of stressful obligations that you have – Reflect on how your activities are serving your higher purpose.  If your job is your main source of stress, you may feel limited on making changes in this area, which is all the more reason to work on stress management skills. 

·      Change the way you react to stressful situations – You do have control over how you respond to stress.  Start by becoming aware of your triggers and response.  Can you acknowledge the fear or anger and then let it go?  It takes mindfulness and practice.

·      Have a practice or habit that helps with managing stress

o   Get enough sleep

o   Exercise or yoga

o   Meditation

o   Acupuncture

o   Counseling

o   Prayer

o   Journal/Write

·      Consider herbal support – There are many herbs that can help manage stress.  Particularly herbs that are known as adaptogens, which refers to their ability to reduce the stress response, are good choices.  Ashwagandha, rhodiola, schisandra, eleuthero and lemon balm are a few examples.