Learn how stress can affect fertility

Fertility Advice

Is your lifestyle affecting your fertility?

Why relaxation time is necessary for healthy conception

I’m going to discuss the modern lifestyle, more specifically stress, and how the effects of long term stress, both mental and physical, can affect our fertility, and what we can do about it. I’m a reflexologist and do a lot of work with clients trying to conceive, or those suffering from the effects of long term stress. Often the two are intrinsically linked.

Stress occurs when our body reacts to a certain situation which puts us into defence mode to trigger the fight-or-flight response. In turn, this:

– stimulates the adrenal glands to produce adrenaline and cortisol,
– increases heart rate and blood pressure,
– constricts non-essential blood vessels, and
– releases blood sugar which gives us the extra energy needed to fight or run for our lives.

Many of the stresses we deal with today don’t involve life-threatening situations – it’s unlikely we’ll meet a club-bearing caveman lurking behind the coffee machine at work! But a lot of us find ourselves in continuous stressful situations, for instance, dealing with rush hour traffic, work difficulties, office politics, long working hours, financial worries, relationship problems, etc, etc. Our bodies are unable to switch off the fight-or-flight response so we interpret more and more things as being stressful, and eventually find ourselves in a permanent state of stress, which over a long period of time will lead to exhaustion. Once we are at this stage, most of our body’s energy is spent on survival, maintenance and essential repairs and non-essential things like reproduction take a back seat until the body is back to a balanced state.

Prolonged stress can have a profound effect on fertility in both women and men. The processes of ovulation and healthy sperm production depend on a complex balance of hormones and their interactions to be successful, and any disruption in these processes can hinder chances of conceiving.

Female Stress

Stress on women and how it affects bodily function

Let’s start by looking at women. Too much stress can upset the pituitary gland which does several vital jobs in the body. As well as controlling growth hormones, it’s also the mission-control centre for your stress hormones and sex hormones. All hormones function at their most effective when they are in balance and if that is disturbed then you can get symptoms that range from mildly irritating to life threatening. In particular, if the stress and sex hormones are out of balance, this can cause all sorts of problems for fertility.

Cortisol is a stress hormone and a deficiency in cortisol is due to the adrenal glands (which also produce adrenaline) becoming fatigued because of long term stress. When we react to stress, our body responds by producing cortisol which competes with progesterone for receptor sites, making the progesterone less active and, after a long period of stress, leads to oestrogen dominance.

Oestrogen dominance can cause various symptoms, including tender or fibrocystic breasts, decreased sex drive, depression, water retention, increased blood clotting, increased risk of strokes, miscarriage, osteoporosis, PMS, fibroids in the uterus and endometriosis. Conversely, if there is too little oestrogen, particularly in the first half of the cycle, it can cause ovulation to happen erratically or not at all.

The real importance lies in the ratio of the reproductive hormones, particularly oestrogen to progesterone, not just their actual levels. Progesterone deficiency is the most common example of hormonal imbalance in women of all ages. It causes various symptoms, including PMS, bleeding between periods, painful breasts, sleep problems, headaches linked to your menstrual cycle, anxiety and irritability. If not enough progesterone is made in the luteal phase, the second half of the menstrual cycle, the lining of the uterus may not be thick enough or rich enough for a fertilised egg to implant, so the entire lining including egg, is lost in a normal period. Unless the luteal phase is longer than 10 days, a pregnancy is unlikely. Progesterone maintains a pregnancy for the first 12 weeks, so a deficiency may cause a miscarriage. Progesterone deficiency may also affect the faulty secretion of other reproductive hormones, such as prolactin.

Over production of prolactin can also be caused by long periods of stress, and this interferes with ovulation. The hypothalamus stops secreting GnRH (gonadotrophin releasing hormone), which in turn affects the release of FSH (follicle stimulating hormone) and LH (luteinizing hormone). FSH stimulates the ovary to develop a new follicle in preparation for the next ovarian cycle and LH helps to create a lipid-rich environment in the ovary. Both these hormones are involved in the production of ripe eggs, so have a profound effect on fertility – no ripe eggs mean no pregnancy.

Oxytocin is the hormone which causes the contraction of smooth muscle fibres and is responsible for powerful contractions during labour. Low levels of oxytocin may compromise fertility by affecting the muscle fibres in the walls of the Fallopian tubes and in the walls of blood vessels supplying the lining of the uterus.

Male Stress

How stress affects male hormone balance

I’ve looked at how stress can affect the delicate balance of hormones in women, and what a massive impact this can have on our fertility. Indeed, if a couple are trying for a baby, it is usually the woman who will do the research and start incorporating lifestyle changes which may improve her chances of conceiving. But what about the men? Is hormone balance so vital with them? And how is it connected with stress?

Well, hormonal processes are similar in men in that the hypothalamus releases GnRH (gonadotrophin releasing hormone) which triggers the pituitary gland to release FSH (follicle stimulating hormone) and LH (luteinizing hormone). Unlike women, a man produces FSH and LH at an even rate throughout the month, enabling sperm cells to be produced and matured constantly. So in theory, he is always fertile. However, this fertility does depend on a perfect balance being maintained between FSH and LH. FSH stimulates primary sperm cells (called spermatocytes) to divide and develop into spermatids (young, tail-less sperm) before they are nourished and develop further into mature sperm – now with tails! LH stimulates specific cells in the testes to produce testosterone which plays a very important part in several reproductive functions, including sexual arousal, the production on seminal fluid and the maturation of sperm.

Men also produce the hormone prolactin, especially when under stress, and this can inhibit testosterone output, leading to decreased sex drive, premature ejaculation, difficulty achieving orgasm and erectile dysfunction. If a man is under continual stress, there will be a constantly high level of prolactin in his system and that may interfere with the hormones controlling sperm production too – FSH and LH.

So, high levels of stress do take their toll on sperm production. Constant stress results in the body fighting on all fronts to get blood to the heart, lungs and brain. Energy needed to make sperm is being used elsewhere so naturally, sperm production suffers and sperm count goes down. Semen samples from men under stress show a decrease in volume and greater numbers of sperm with abnormalities.

Pregnancy & Sex

Pregnancy & Sex

Stress not only causes fertility problems, it can also prevent you from becoming and staying healthily pregnant. Some research suggests that stress causes infertility because it produces malformed or immature eggs or sperm, or both. Pregnancies created by a damaged sperm or egg usually result in miscarriages, often so early that you may not even realise you had conceived.

So with all this stress going on, what happens to our sex drive? For women, libido is powered by oestrogen and a small amount of testosterone. Long term stress means too much cortisol and prolactin in our systems, in turn affecting production of fertility hormones.

– Too much oestrogen can cause a loss of libido,
– Too little oestrogen can cause vaginal dryness and painful sexual intercourse,
– Too little progesterone can diminish libido, and
– Too little cortisol can cause loss of libido.

Again, it comes down to the delicate balance of hormones. Low sex drive usually means you don’t have much sex, which is of course a prime cause of infertility. Imbalanced hormones coupled with the long hours that we Brits insist on working, mean that we are often too tired or simply not in the mood for sex at the end of the day.

Long term stress is also a well-recognised cause of clinical depression, which is another adversary of sexuality and fertility. With depression, you may experience a wide range of symptoms. Many lose the desire for sex, or feel little or no sexual pleasure during intercourse. Depressed men may experience erection or ejaculation problems, or difficulty having an orgasm.

Dealing with Stress

Dealing with stress

So, I’ve shown that living with long term stress can have a major impact on our ability to conceive, but how do we deal with it? Remember, stress is caused by a reaction to a situation, not the situation itself. Everything depends on how you interpret and respond to it. Getting to the route of the problem and tackling it together is a starting point. And making some lifestyle changes can help to manage the stress you are living with.

Good nutrition is essential, and ideally cut out stimulants which can exacerbate stress such as caffeine, alcohol and cigarettes. A good night’s sleep reduces stress and allows the body to regenerate and heal. Self-help techniques such as meditation or visualisation are very useful. Complementary therapies such as reflexology or acupuncture are very good at restoring balance, particularly in relation to hormones. Regular exercise is also a great way of relieving stress and boosting fertility, however, too much exercise can have the opposite effect.

Regular exercise, by which I mean about 3 times a week, should fit in comfortably with your normal schedule and should be something you enjoy. There is no point turning exercise into a stressful situation by travelling miles, rushing to get to a class on time or whatever! It can improve your well-being at every level and is particularly good for those trying to conceive as:

– it relieves stress and anxiety,
– promotes restful sleep,
– increases blood flow to supply the whole body, and especially the reproductive organs, with essential oxygen,
– alleviates the symptoms of PMS,
– boosts the immune system and
– prepares the body for pregnancy – if you are physically fit you are less likely to suffer from morning sickness, constipation, etc and more likely to have a shorter labour.

Ideal forms of exercise are those which tone muscles and build up fitness gradually, for instance swimming, brisk walking, cycling or yoga. However, strenuous exercise more than 3 times a week can have the opposite effect from what you have in mind, and put your body under such physical stress that it can actually inhibit your chances of conceiving.

In men, excessive amounts of punishing exercise (such as long distance running) can reduce testosterone production temporarily and therefore lower sperm count. In women, excessive exercise can cause oestrogen levels to fall and periods can stop altogether. It can also lead to weight loss which can have huge implications for fertility.

You are more likely to get pregnant if you are around the right weight for your height, ie not too overweight or too underweight. BMI (body mass index) charts, which measure your total body fat content, can be useful, but it is worth bearing in mind that the optimum weight for fertility is about 10% higher than the optimum weight for general health. A certain percentage of body fat is essential for fertility. Women are meant to be fatter than men for a very good reason – we need it to ovulate. Girls do not start their periods until they have at least 17% body fat and the average woman has 27% of her weight as body fat.

Being underweight by more than 15% can stop you ovulating. Too little body fat may cause oestrogen levels to fall and periods can be intermittent or may even stop altogether. It may also affect the quality of cervical mucus. The body also needs to know that there is enough fat present to nourish a pregnancy and carry it to term. Pregnant animals will spontaneously abort if their food supply is threatened. I once visited the Cape Cross seal colony in Namibia, where over 100,000 seals are crammed together on the beach and in the sea. There are never enough fish in the surrounding sea to sustain them all, so premature birth and starvation are 2 of the most common causes of death. Humans aren’t so very different – we need a certain amount in reserve to conceive in the first place, and then to sustain a healthy pregnancy.

Reflexology

Reflexology

As I mentioned before, I’m a reflexologist. For those of you who don’t know much about it, here’s a little background information. Reflexology is a therapy based on the theory that all the organs, glands and systems of the body have corresponding reflex points in the feet and hands, so that they are like mini maps of the body. By stimulating these reflexes, a treatment can clear congestion in a particular area and maintain a healthy balance in mind and body. It is a deeply relaxing and calming experience. A regular reflexology treatment is a good form of preventative medicine because it can reach an area of pain or tension before it becomes chronic.

Reflexology was first practised by the ancient Egyptians dating back to 2300 BC. Chinese medicine has used reflexology for many centuries. Modern reflexology was developed by Eunice Ingham, an American physiotherapist, in the 1930s.

Reflexology is a natural therapy which supports your body’s capacity to heal itself, so it is safe and suitable for any age group, from babies to the elderly. It aims to get the mind, body and spirit back in balance so can help with a wide range of physical and emotional conditions, including stress, anxiety and many related ailments.

A reflexology treatment is an ideal way of coping with long term stress as it will:

– immediately relax you and reduce your stress levels
– trigger your body’s own healing mechanisms and boost your immune system
– improve your circulation and stimulate the lymphatic system to help cleanse your body of toxins
– encourage a state of balance, particularly in relation to the nervous system and endocrine system
– revitalise your energy
– give you an hour of essential ‘time out’ completely to yourself

The philosophy behind reflexology teaches that your body is divided into ten vertical zones, running from your head down to the reflex areas in your hands and feet, and from the front to the back of your body, so here is how it actually works. All body parts in each zone are said to be linked by energy pathways which allow our vital energy (also known as ‘chi’ or ‘prana’) to flow freely, meaning that we are in good health. If this energy becomes stagnant, or blocked completely at a particular part of the body, due to injury, illness, stress, etc, this often manifests itself as crystalline deposits in the feet.

A reflexology treatment aims to break down these crystals, and stimulate our energy, allowing it to flow freely again, relieving the area of pain. Firm massage will also increase the blood and lymph circulation to that reflex area, and the corresponding area of the body promoting good health and a sense of balance in mind and body.

I have taken further courses in maternity reflexology, so have a wide range of experience working with the whole pregnancy sequence – from pre-conception and fertility issues, throughout the whole pregnancy (including the first trimester) to labour, birth and post-natal health. I also work regularly for a mental health project so am particularly accustomed to working with depression, stress, anxiety, panic attacks, obsessive compulsive disorder and other mental health issues.

For clients with fertility issues (especially irregular periods and hormonal imbalances), I pay particular attention to the reflexes relating to all the reproductive organs to detect possible congestion, and to all the endocrine glands, especially the pituitary, hypothalamus, ovaries and adrenal glands. I also use a special technique aimed at balancing all the glands in the endocrine system, and other techniques for calming and grounding.

Often when clients first come to see me they find it quite difficult to switch off. It can take a couple of treatments for them to learn to relax, but they soon start noticing the benefits, such as:

– sleeping well,
– their menstrual cycle becomes more regular,
– they feel less stressed,
– and in several cases they have gone on to conceive and have a healthy pregnancy.

I’m aware that this paper is full of a lot of information, but with the title of the paper in mind, hopefully it has made some sense. In a nutshell, what I’m trying to say is this: If your lifestyle is particularly hectic and you feel you are in a permanent state of stress, then yes, it probably is affecting your fertility. Long term stress causes hormonal imbalances which in turn greatly reduce your chances of conceiving. So aim to get your life (and therefore hormones) back in balance.

Make some changes to your lifestyle – slow down, incorporate some relaxation time such as regular reflexology sessions, take gentle exercise and create some time and space in your life, not just for you, but for a possible addition to your family. If your life is too full at the moment, do you have the time and space for another person to join? I’ll leave you to ponder that thought.

Article submitted by
George McCulloch, Reflexologist, GSSR, MAR

Date published
14/10/08


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