We all hear about how stress affects fertility, but the question is how? There are several key hormones affected by high stress levels, both acutely and from prolonged stresses, and high stress can also exasperate other conditions related to infertility such as polycystic ovarian syndrome or thyroid health.
If you have high stress in your life (which may now be amplified by fertility concerns), please keep reading. First we will look at how stress is affecting your physiology, then recommended testing to determine how it is affecting you, and finally treatment strategies.
Here are some specifics on how stress may be affecting your fertility:
- Stress affects progesterone production in the luteal phase of the menstrual cycle. This can cause ‘luteal phase defect’, or simply affect implantation in the luteal phase.
- Stress affects blood sugar regulation which in turn will worsen hormone balance in women with polycystic ovarian syndrome (PCOS).
- Stress increases inflammation in the body and can worsen inflammatory conditions related to infertility: hypothyroidism, autoimmune conditions, endometriosis and the presence of any autoimmune antibodies.
- Stress increases prolactin levels which then inhibits ovulation.
- Stress also affects the surge or LH (luteinizing hormone), which is a pituitary hormone responsible for beginning ovulation.
- Stress has also been found to reduce cervical mucous, and reduce the thickness of the endometrium by affecting estrogen levels. Both of these factors will impair fertility.
- And finally, when you are under high stress, there is naturally less interest in intercourse, meaning less opportunity to conceive.
From the above notes, it looks like your body has many protective strategies to protect against pregnancy when stress is high. It is absolutely key to reduce stress in your life and balance stress hormones if you are having difficulty conceiving.
The first line of testing if you suspect that stress may be affecting your fertility, is to specifically look at stress hormone levels. I recommend saliva testing for a four point cortisol rhythm with DHEA levels, as saliva levels more accurately measure tissue level or hormone tend to reflect symptoms more accurately. The most accurate test is an “Adrenal Stress Index test” (a salivary hormone test).
Additional related testing would include: a thorough thyroid blood panel (because thyroid function is directly impacted by stress); prolactin levels; blood levels of DHEA (an adrenal reserve hormone that goes down with age and chronic stress); mid-luteal phase progesterone levels; and gluten-antibodies (gluten intolerance or celiac disease is a significant stress on the body). It is also helpful to do basal body temperature charting, as you will notice improvements in your luteal phase temperatures as stress levels are lowered.
How to treat it:
- Follow a blood-sugar balancing diet. This means eating regularly through the day (every 3-4 hours), and having protein with each meal (vegetarian or animal source).
- Balance stress hormones: Depending on your test results, natural supplements can help rebalance stress hormones. It is essential to know what your levels are to be most effective in treatment as certain supplements will raise cortisol, while others can lower it.
- Replenish DHEA if it tests low. DHEA is an adrenal reserve hormone that goes down with age and chronic stress. I have seen low DHEA associated with poor egg quality or poor ovarian response, and often response changes with DHEA support.
- Practice stress relieving activities. Adopt a daily practice for a minimum of 20 minutes of some activity that puts you into a deeply relaxed state. This could be active as in yoga or Tai Chi; or passive as in guided imagery, breathing exercises, meditation or prayer. You will find that over time, this short daily practice spills over, creating more relaxation in the rest of your life.
- Take regular breaks in your workday. One simple strategy to prevent stress hormones from climbing during a busy day is to remember to take regular breaks. These help to reset your nervous system and will allow you to be more productive and less anxious as the day goes on. Book at least a 10 minute break every 3 hours.
- Seek support. You may need extra support in your journey towards fertility in the form of psychotherapy or a support group. If you are feeling alone, please look for help – there are many great support systems out there.
- Start regular acupuncture treatments. Along with balancing hormones, this is one of the most effective ways to calm down the sympathetic nervous system, or the part of the nervous system that drives the stress.
Recognizing that stress may be affecting your fertility, or taking action before trying to conceive can make a profound impact on your overall health as well as fertility. If you would like further information regarding testing or treatment, please ask at your next appointment.