Could Stress Be Affecting Your Fertility?


Could Stress Be Affecting Your Fertility?

The Effects of Stress on Fertility

Adrenal health is one of the most talked-about topics in health today, and for good reason. We lead hectic lifestyles, are constantly on the go and stimulated by wireless technology, rarely getting deep restorative rest. Our life style is so much faster than twenty years ago, we are all trying to adapt—often at great expense to our health.
The adrenal glands are two small, triangular glands that sit right on top of your kidneys. These glands have a very special job to do: they secrete crucial hormones in response to stress. The outer part of the adrenal gland is called the cortex, and it secretes cortisol and male hormones (androgens) like DHEA. It’s really important to know that the adrenal cortex is controlled by the pituitary gland, which is a small, pea-sized structure within the brain. The pituitary is actually considered the “master gland”, as it controls most of the hormone function in the body, and the connection from the brain to the adrenals is called the hypothalamic pituitary adrenal axis (HPA axis).
Stress is particularly detrimental to reproductive hormonal balance.
In a normal menstrual cycle, there is a predominance of oestrogen that rises up until the time of ovulation at mid-cycle. After ovulation has happened, the progesterone levels should rise, and the second phase of the cycle is dominated hormonally by progesterone(Progesterone is needed to help embryos implant into the endometrial lining of the uterus). There needs to be a good balance between these two hormones for normal cycling and healthy fertility to be possible.
Knowing that cortisol is released in times of stress, it’s important to have a look at the way that cortisol is made – cortisol is actually synthesized from progesterone. Thus, if you are under stress, and your adrenals need to make more cortisol, they are going to use up whatever progesterone you have to do it. This “theft” of progesterone by your adrenals can result in further disruption of your cycles, inability of embryos to implant, and miscarriage.
High cortisol causes insulin resistance, and after an elevation in cortisol, insulin resistance develops 4-6 hours after said elevation and persists for more than 16 hours. If you suffer from PCOS, cortisol aggravates the insulin resistance that you may already have present. Insulin resistance and high insulin levels also delay ovulation, cause excess androgens to be produced, and increase fat storage.
High cortisol causes abnormalities in the way that many of the sex hormones and thyroid hormones work in the body. Raised cortisol levels make the cells in your body less able to use oestrogen, progesterone, and thyroid hormone, and also reduce the conversion of the inactive form of thyroid hormone T4, into the active form of thyroid hormone T3. High cortisol also reduces the cellular sensitivity to thyroid hormone.
Basically, stress makes your hormones work in a less effective way.
Stress can also decrease your fertility in many ways:

  • Impairs follicle health and development – stress reduces the secretion of oestrogen 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.

Stress and Fertility: 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.
Stress and Fertility: Effects on IVF and 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:

  1. Measurement of stress through laboratory testing: blood tests: am and pm cortisol, adrenocortex stress profiles.
  2. Urinalysis for adrenal stress hormones
  3. Assessing for physical signs and symptoms of stress
  4. Orthostatic blood pressure testing

Here are a few tips to restore the adrenals and reduce the effects of stress:

  • Yoga, meditation, breathing, and mindfulness activities are restorative to the hypothalamic- pituitary-adrenal axis. Practice daily for best results as well as going to a class activity with a qualified instructor.
  • Going to bed by 10pm is ideal: Cortisol reaches its lowest point at 11 pm, and melatonin begins to peak at 1 am. A 10pm bedtime allows deep sleep to set in, prevents a second wind, and promotes a healthy balance of melatonin and neurotransmitters. High quality sleep is crucial to adrenal health.
  • Reduce sugar and high glycaemic carbs, as ups and downs in blood sugar stress your adrenals.
  • Eat whole, natural foods, and eliminate processed foods. Include high quality sources of protein and fibre to help regulate your insulin.
  • Eat breakfast by 9 am at the latest.
  • Minimize caffeine.
  • See a counsellor or psychologist or specialised practitioner who can help you to learn the tools to manage stress.
  • Learn to say “no”. Know your limits, and enforce them to protect yourself from stressful situations.
  • Adrenal tonics: many herbs and vitamins can help reduce stress and can assist your body to adapt to stress.
  • Reduce your toxic load, use natural household cleaners, avoid passive smoke, drinking from plastic bottles and excessive use of your mobile phone.

In our increasingly busy world, long working hours translate as physiological and emotional stress, don’t delay seeking assistance in managing stress, as it is now one of the biggest risk factors in leading to chronic disease conditions. It’s really important to give yourself the opportunity to heal from the weight of stress if you are trying to conceive.

Jacky Dixon
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