Dr. Sarah Penney, ND, MSc
Stress and Fertility
The age old question of 'which came first' applies more than ever to our increasingly prevalent reproductive issues and emotional concerns - so let's talk about how infertility can cause stress and how stress can contribute to infertility. Research has estimated that up to 16% of couples who are of reproductive age may experience fertility issues, defined as inability to conceive after unprotected intercourse for 12 months. Fertility clinics have lineups of patients paying thousands of dollars for procedures, and these days by our late 20s it is not uncommon to know someone who has struggled with this issue. Many women even start their reproductive journey with fears of infertility due to experiences of family and friends, or concerns about factors like age. If you have been trying to get pregnant, you no doubt know some of the stressors this process can bring. After deciding you want a child, you might start feeling some grief and disappointment with every passing period and anxiety or excitement at the signs of ovulation. It is truly an emotional roller coaster.
If anyone outside of your relationship knows your plans, innocent inquiries about any progress can become depressing and top of that, all you see anywhere you go is pregnant women and babies. You have also tried everything you can find on google to boost your odds, from drinking 1L of pineapple juice after sex to standing on your head when you ovulate (I made these up - don't try them, but I have come across wilder home remedy suggestions). Between the tracking of your temperatures, cervical discharge, breast tenderness, and urinary ovulation predictors it can be enough to drive anyone crazy. I am certainly not blaming you for being stressed.
So what does stress have to do with it? The effect that stress and it's hormone of choice, cortisol, can have on our fertility has been long studied. Although opinions are mixed, research has demonstrated some surprising effects like the apparent ability of stress to inhibit ovulation. This has specifically been shown by measuring salivary levels of a hormone called alpha-amylase. (1) Physiologically, it is also possible that stress could affect fertility by decreasing blood flow to reproductive organs. When your body is under the control of cortisol and other stress hormones, it prepares for 'fight or flight' - and inborn reaction that preps us to face a physical threat. The change that concerns fertility is focused on the fact that to deal with a threat, our body changes blood flow to provide more nutrients to our muscles, thus shunting blood away from less acutely important systems like our digestive tract and reproductive organs. Stress may also effect hormone levels, evident by the fact that this is not entirely uncommon to skip a period during a time of high stress.
Alright, so enough with all this stress is bad talk – sometimes it is even worse to get down on yourself for feeling stressed. No matter how you choose to deal with stress – it is an important thing to address it if fertility is in your future. The patients I see in my practice as a naturopathic doctor largely benefit from tools such as counselling, journaling, nutrient support, positivity and of course acupuncture to calm the mind. Others find relief from exercise, talking to friends, more laid-back intimacy with their partner, or simply knowing that they're doing all they can. Talk to your doctor about fertility investigation and what else you could be doing if this is becoming a concern or stress for you, or consider consulting a naturopathic doctor for help dealing with stress. You are not alone!
Dr. Sarah Penney, ND, MSc
1. Louis GM1, Lum KJ, Sundaram R, et al. Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. Fertil Steril. 2011 Jun;95(7):2184-9.
As originally written for acenutrients.com