Throughout evolution, there have been indicators that stress impacts reproduction. And why wouldn’t this make sense? From an adaptive perspective, an acute increase in stress was designed to stimulate the “fight or flight” response, thereby marshalling resources for survival, not reproduction.
The stress response alters physiologic processes—it diminishes, for instance, the production of hormones that encourage reproduction—to focus on the stressor situation. In addition to causing hormone abnormalities, stress can impact one’s ability to become aroused.
A sluggish reproductive system is not the only manifestation of the stress response; other negative effects may include eating disorders and digestive problems. All of these can lead to challenges with family planning.
For many years, scientists and clinicians have struggled to explain the physiology behind these symptoms. It is now understood that “cortisol” is the stress hormone, and it becomes elevated when you’re under duress. The increase in this hormone negatively impacts the main reproductive hormone, “gonadotropin-releasing hormone” (GnRH). Suppression of GnRH ultimately causes suppression of testosterone, estradiol, and sexual behavior. The final results: decreased sperm count, ovulation, and reproductive activity.
Although treatments have been developed to bypass stress effects by adding hormones back into the system, this has been met with varied response. In humans, chronic stress cannot only decrease sex drive, but also negatively impact fertility. In fact, as suggested by many anecdotes about couples conceiving children after the failure of assisted reproduction, the fertility treatments themselves can cause sufficient stress to decrease their effectiveness.
In 2000, a new hormone was discovered: Gonadotropin-inhibitory hormone (GnIH). First identified in birds, it causes the opposite effects of GnRH. It suppresses reproduction. The equivalent hormones in mammals have been shown to increase with acute stress, but they return to normal within a day. However, chronic stress results in longer-term elevations of these stress hormone levels and lower sexual activity in mammals. The idea is out there of developing a means of blocking GnIH to reduce some of the effects of stress on reproduction.
Further research of GnIH could potentially lead to many additional applications. These include treatment of endometriosis, uterine fibroids, benign prostatic hyperplasia, as well as prostate and breast cancer. Human GnIH may also have potential as a novel form of birth control.
But, for those trying to conceive, the message is clear: decrease your stress. The options for how remain varied and somewhat individual. Here are some sound suggestions.
Acupuncture. A form of traditional Chinese medicine, acupuncture uses pressure points, which are situated on meridians along which qi, or ch’i (“life energy”) flows. Studies that have looked at the addition of acupuncture to fertility treatments have demonstrated decreased stress and increased blood flow to the pelvis, which is where hormones must act in fertility treatments. Studies looking specifically at pregnancy rates show varied results.
Exercise. Physical activity plays a key role in reducing and preventing the effects of stress. Studies suggest that at least thirty minutes of exercise, three times per week will help release pent-up stress and tension.
Healthy Diet. Well-nourished bodies are better prepared to cope with stress, so remember: “you are what you eat.” Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day.
Decrease your caffeine and sugar intake. The short-lived “energy highs” that caffeine and sugar provide often end in a mood and energy crash. Reduce the coffee, soft drinks, chocolate, and sugar snacks in your diet. The results: you’ll feel more relaxed, and you’ll sleep better.
Avoid alcohol, cigarettes, and drugs. Using alcohol or drugs to escape stress provides an easy, but temporary, relief. It is essential to deal with the issues at hand with a clear mind.
Get enough sleep. We often attempt to function at the speed of light, sacrificing sleep for an extra few hours of work and activity. Adequate sleep helps your mind, as well as your body. Fatigue will only increase your stress.
Technicalities and science aside, let’s not forget the joys to be found in family planning, which themselves can be great stress reducers.
Dr. Shlain is the medical director for Current Health Medical Group.
Dr. Lane is the Medical Director of Golden Gate Fertility Center (goldengatefertilitycenter.com) and co-Founder of Family First Donor Program (familyfirstdonorprogram.com)
