Everyone experiences some level of stress in their lives no matter what. From commuter problems, family stressors, tight deadlines or even the endless connectivity that comes with our smartphones, we can all become spread a bit too thin sometimes. But, can stress have an effect on fertility? We spoke with Dr. Brooke Hodes-Wertz, assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Health for her expert advice.
What is stress, really?
If you ask 10 people to define stress, you're probably going to get 10 different answers. But what is it, in medical terms? Hodes-Wertz explains, "Stress can be viewed as mental tension or often a physiological reaction to stimuli that feels threatening. When stressed, the body it switches to 'fight or flight' mode where it releases hormones such as adrenaline, cortisol and norepinephrine. These hormones have effects throughout the body." She adds that when stressed, your body can shift blood flow way from non-vital organs to the heart, brain and muscles.
How can stress affect fertility?
For starters, being stressed out can make performance in the bedroom difficult, and can lead to a reduction in the frequency of sex, too. "For women, this shift to 'fight or flight' mode involves shifting energy away from the reproductive axis and can lead to irregular ovulation or even stop ovulation and menses altogether," explains Hodes-Wertz. She adds that for women who have regular cycles, the effects of stress are more difficult to measure.
Can stress affect a pregnancy?
In short, maybe. Hodes-Wertz explains, "One of the hormones released during times of stress is corticotropin-releasing hormone (CRH). While some studies have shown elevated CRH in women with preterm deliveries and miscarriages, it is not clear if the high levels of CRH are leading to the poor pregnancy outcome." She notes that, "measuring the effects of stress in pregnancy is complicated by difficulty defining and measuring stress especially throughout the different trimesters of pregnancy."
What the research says.
While the findings aren't always crystal clear, research has shown that stress can correlate with difficulty conceiving. Hodes-Wertz says, "Stress is highly correlated with women having difficulty conceiving but it is not known whether the infertility is causing the stress or what the role of stress has in contributing to the trouble conceiving. Even though infertility is very stressful, there is mixed evidence on whether stress causes infertility. Stress is hard to study in patients trying to conceive as it is hard to measure, and people process stress in different ways." However, she explains that there are no clinical trials which demonstrate definitively that reducing stress prior to infertility treatment improves pregnancy rates.
How to lower your stress.
In general, lowering your stress level is always a good idea, and even more so now. Hodes-Wertz recommends cognitive behavioral therapy, yoga/exercise, and acupuncture as ways to feel less stressed. She notes, however, that, "trying to conceive can be stressful in and of itself," and that unfortunately, "many patients experiencing these symptoms fail to seek therapy."