Stress & Fertility
The holidays are here, which may make you excited, or the thought of all the shopping, get-togethers, and festivities may send you running for cover—especially if you’re also trying to add one more thing to your to-do list: get pregnant. Here’s what you need to know about stress before you get under the mistletoe this year.
Stress is hard to avoid, and its effect on our bodies is complex. When we are feeling stressed, our bodies are perceiving a threat—whether that threat is being chased by a predator like our ancestors were or a looming deadline at work—the result is the same within our bodies: the fight-or-flight response. Our brains see the threat and tell the body to increase adrenaline (epinephrine), cortisol, and other hormones through our hypothalamic-pituitary-adrenal (HPA) axis to allow us to have the stamina to evade the predator (or your boss asking about your report). Every body system is affected: our muscles use fuel differently, our pupils become dilated, the heart beats faster, blood flow to vital organs is prioritized over organs that are for digestion and, yes, reproduction. Our bodies are adapting to the threat to survive. “This is not the time to get pregnant,” is what our brain is telling the rest of our body.
Once the stress hormones are ramping up, the brain delays or stops the production of luteinizing hormone (LH), which is responsible for triggering ovulation. If ovulation does occur, our bodies are so busy shunting hormone production towards stress hormones, that the amount of progesterone produced in the luteal phase after ovulation is lower. Lower luteal phase progesterone could mean that the uterus is not prepared well enough to have a fertilized egg implant itself.
If you are cycle charting, you might notice that you ovulated later in your cycle (maybe day 18 instead of your usual day 14), which will cause your entire cycle to be longer than usual (maybe 32 days instead of 28). You could also notice that the second half of you cycle (the luteal phase) is shorter by a day or so, thanks to the lower progesterone produced during stressful times.
Even if the physiology of stress’s impact on fertility makes sense (our ancestors didn’t want to have a child in the middle of a famine, for example), each woman might perceive and cope with the same stressors differently. This can make the role of stress in fertility difficult to measure, but a recent study of 259 healthy, premenopausal women found that perceived daily stress was associated with less favorable levels of estradiol, progesterone, LH, and FSH (follicle-stimulating hormone) and increased likelihood of anovulation (not ovulating during a cycle).
Limiting stress is easier said than done (especially during a month with extra time commitments or when trying to conceive IS the stressor), but some ways to decrease how threatening we perceive the stress include cognitive-behavioral therapy, individual therapy, mindfulness, deep breathing exercises, guided meditation, yoga, light exercise, and carving out time for hobbies whenever possible. One study even found that women facing infertility who received counseling or other mental health support were twice as likely to get pregnant as those who did not. These methods can help decrease the amount of stress hormones produced.
Cycle charting is essential any time you are trying to conceive, but especially so during stressful months. By knowing how stress hormones might shift your fertile window and lengthen your cycle, you can plan accordingly, and avoid unnecessary added stress and enjoy the holiday season.
Catherine Needham is from Chattanooga and joined the Designer Drug team in 2013 after earning her PharmD at Samford University in Birmingham, AL. Catherine consults with patients regarding their hormone levels and makes recommendations to providers for bio-identical hormone replacement therapy. She is also interested in functional/anti-aging medicine, infertility, and dermatology. In addition to serving as a Samford University preceptor to teach 4th-year pharmacy students, Catherine is a worship leader at her church. She and her husband have 3 young boys and a dog.
