Stress and fertility
Is stress contributing to your infertility and hormonal problems?
The short answer is that if stress is a major factor in your life, it is most likely having an effect on your hormones.
Our body adapts to stress very quickly, adaptability is what has ensured human survival. However long-term adaptation to stress tells our monkey brain “hey, it’s not a good time to reproduce, I’m too busy running away from a woolly mammoth” (were we alive at the same time as woolly mammoths? Look, I’m a naturopath, not a historypath). This “quick, run from the mammoth” is called the fight or flight response. Our body is meant to be in fight or flight for short periods of time, however modern day stress has us in this state more frequently than we are programmed for. When we are constantly in fight or flight instead of rest and digest, our body increases stress hormones that block hormonal release from our reproductive system.
Stress is more than just long days and deadlines to meet at work. Over-training at the gym, under-nutrition, chronic illness, and psychological stress all contribute to hormonal dysfunction and infertility. We are constantly challenged with stressors in daily life from big things like the death of a family member, a relationship break up, not being able to cover rent, living through a pandemic (hello 2020), to smaller issues like being caught in traffic or queueing in line for too long. Our bodies cannot tell the difference between physical and psychological stress and the stress hormone release (adrenaline and cortisol) is the same for a break-up as it is for a run from a lion.
How does it work?
The hypothalamic-pituitary-adrenal (HPA) axis (how our brain and adrenal glands talk) directly inhibits the hypothalamic-pituitary-ovarian (HPO) axis (how our brain and ovaries talk to each other). So basically when we are stressed our body pumps out excess stress hormone, and this inhibits our reproductive hormones. Long-term stress suppresses luteinizing hormone (LH) release from the brain. LH is the trigger that releases the egg from the ovaries during ovulation. When LH is suppressed, ovulation is thrown out of whack, or sometimes doesn’t happen at all.
Everyone’s response to stress is different, depending on the type and duration of stress, personality type, stress coping mechanisms and their genetics (even depending on how stressed your parents where while you were in the womb can affect your HPA axis!). Ovulation, sexual behaviour and embryo implantation are the areas most effected by stress.
Acute stress is a stress that only lasts a few hours, but if this carries on for months, even at low levels, it’s called chronic stress. Acute stress impairs reproduction if it happens during critical times in the menstrual/ovulatory cycles, whereas chronic stress impairs reproduction in general.
Chronic stress can progressively lead to decreased lean muscle mass, decreased wound healing, increased visceral fat (the bad fat around your organs) and insulin resistance. There is a big link between chronic stress and PCOS due to the insulin resistance, anovulatory cycles and increased body mass.
What you can do to reduce stress, and normalise reproductive hormones:
- Nutrition – Eat healthy, high fibre, balanced meals and avoid processed, high sugar foods.
- Avoid stimulants – Coffee and energy drinks will automatically increase your cortisol.
- Sleep – Aim for at least 7 hours a day to reduce stress and ensure adequate rest. Hormones are released during sleep that help our body to repair and recover.
- Exercise – Exercise moderately at least 5 days a week, for half an hour a day. Alternate exercise types and challenge your body.
- Deep breathing – This is my favourite, breath in for 5 seconds, imagining a balloon inflating under your diaphragm, and then out for 10 seconds. Repeat this whenever you are feeling stressed, or at least twice a day for 2 minutes. This actively brings your body out of fight or flight and into rest and digest.
- Grounding – Basically this involves taking your shoes off, walking in nature and letting our feet touch real soil/grass (it surprisingly doesn’t happen much unless you take the time to connect with nature and the earth in this way).
- Speak to a professional – This one is close to my heart. Please don’t bottle up your feelings, and let them swish around in your head and fill it up, call Lifeline 24 hours a day on 131114.
- Bring joy into your life – do one thing before lunch every day that you actually enjoy. Write a list of things you enjoy and do them! Here are some things on my list: gardening, face-masks (the pampering type), yoga, reading, patting my cat, kissing my baby, phone free time talking to my fiancé over breakfast.
- Herbal medicines that help you adapt to stress such as Withania, Schisandra and Rehmannia
- Calming herbal tea, baths, aromatherapy with essential oils such as lavender, meditation, journalling… Find the things that specifically calm you, and incorporate them into your life.
This study was the basis for much of my research, click here for further science-y talk on the topic
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