Anxiety and Fertility

If you’ve been in the trying-to-conceive (TTC) world for any amount of time you are probably familiar with the bad and likely unsolicited advice that sounds something like…

“If you just go on a vacation and have a few drinks you’ll get pregnant.”
“You just need to relax.”
”You stress too much. That’s why you’re not pregnant yet.”
“Just stop thinking about it so much.”

These statements are all examples of unhelpful and half-ass support and advice, however, we can’t throw out this notion completely. Stress does have an impact on our entire body and our fertility is no exception.

What Is Stress?

For our distant ancestors, stress looked a lot different than today and in many ways we can be thankful for that. Life-or-death situations, like famine or being chased by a predator were not uncommon then, and therefore relied on the body’s fight-or-flight mode for survival. Even though we aren’t in these exact scenarios today, our fight-or-flight mode is still being activated on a daily (and even minute-by-minute) basis and for reasons you may not expect.

You have probably heard of the nervous system, maybe in a health or anatomy class way back when. But you likely didn’t learn how your nervous system is interconnected with your reproductive system.

Your nervous system is responsible for regulating your stress via the autonomic nervous system (ANS). The ANS has two modes: parasympathetic and sympathetic. To make it a little easier to understand how your nervous system impacts your fertility, I’ve come up with some nicknames: “welcome baby” mode (or parasympathetic) and “no place for baby” mode (or sympathetic).

Parasympathetic or “Welcome baby” Mode

You know the feeling when you have to quickly slam on the brakes to avoid rear-ending the car ahead of you who didn’t put on their turn signal? “Welcome baby” mode is activated only when the immediate stress response that allows your body to respond appropriately to avoid the accident ends. Once your brain senses that the emergency is over, this part of your parasympathetic mode tells the body to slow your quickened heart rate, decrease your adrenaline and blood pressure, and bring back blood flow to the internal and reproductive organs after it was shunted up to your brain and arms so that they could react quickly enough. 

Phew!

Parasympathetic mode, often referred to as the “rest and digest” system, is what allows your body’s daily operations like digestion, hormone balance, body temperature regulation, and reproduction to thrive.

This mode is a must-have to communicate to your body that you are not constantly in a state of emergency and it’s in a safe environment to create and bring a baby into. When your body can spend enough time in “welcome baby” mode, fertility hormones can better be produced and in the proper amounts, your period will be on time and pain-free, and sperm production (for men – obv) will be at its peak, creating the most conducive environment for your baby. 

Sympathetic “no place for a baby” Mode

Sympathetic mode, often referred to as the “fight-or-flight” system, quickly and automatically prepares the body for emergencies and life-or-death situations. Put yourself back into the almost rear-ending the car situation from above for a moment. 

When your brain detects danger, your body responds by increasing your heart rate and blood pressure, inhibiting digestion, stimulating adrenaline production, and shunting blood away from your internal and reproductive organs to your extremities in order to help you either fight or run away from the danger and (hopefully) survive the situation. We can be very thankful that our body can respond without us even having to think in times such as this!

Can you imagine how high your insurance policy would be if not??

But I’m not THAT Stressed…

The problem arises when your “no place for baby” stress response gets activated on a chronic, low-grade level for many hours a day week after week without getting shut off and the body gets stuck in “no place for a baby” mode. Think: Stop-and-go traffic on a daily commute that puts you in a pissy mood all-day long, back-to-back work deadlines with no end in sight, swiping through your social media feed and comparing yourself to everyone and their mom 24/7, even those “healthy” exercise and nutrition habits that you’ve been working so hard to implement can do it too if they aren’t right for your unique situation. 

These may not seem like life-or-death, fight-or-flight situations to you, but unfortunately the brain and body perceives them as such and it may be keeping you locked in sympathetic dominance if you don’t do anything to stop it. Some people think that a high-stressed, “sleep-when-you’re-dead” lifestyle is synonymous with being a high performing, goal- oriented, and overachiever, which may be true… but can come at a significant cost to your health and fertility. 

And Let’s Face It, TTC Can Be STRESSFUL!

We were taught in grade school that you can get pregnant at any point in your cycle and “it only takes once”, so be sure to protect or abstain. Unfortunately, most women don’t learn the truth about their fertility and their cycle until they start TTC or start experiencing symptoms of hormonal issues. On top of that, many of my clients have issues finding supportive doctors and practitioners that either (a) simply throw their hands up and tell them to come back for fertility testing after a year of trying (or in some cases after 3 miscarriages) or (b) try to push them to jumping into IVF or sperm/egg donors when they are not quite ready for that. Throw in some concerning health/fertility symptoms and of course, the highs and lows of timing your sex and testing after the two-week-wait every month – and it’s no wonder that so many of my clients experience with unmanaged stress.

How Stress Can Impact Your Fertility

The communication channel between your brain and your reproductive organs is called the Hypothalamo-Pituitary-Gonadal (HPG) Axis. The HPG axis has an overwhelming impact on your endocrine (hormone) system which includes the brain, thyroid, adrenals, ovaries, and testes and is directly impacted by stress. The hypothalamus in the brain is a critical processing center which receives constant stimulus from your environment. In the hypothalamus, the main stress hormone, cortisol, has a dampening effect on the secretion of GnRH, which triggers the pituitary to release FSH and LH which are directly related to the production of estrogen, progesterone, and testosterone. 

Precise levels of glucocorticoids (stress hormones) are required for proper gonadal function; where the balance is disrupted, so is fertility…

What the heck does all that mean?

Constant and unmanaged stress (even accidental stress like not eating enough, working out too much for your hormones, watching too much news, etc.) negatively impacts fertility hormones which can mean potential fertility problems for both men and women. 

Symptoms that stress may be affecting your fertility may include:

• PMS and period problems in women (especially amenorrhea or an irregular period)
• trouble getting pregnant
• miscarriage
• poor sperm makers in men
• poor egg quality in women
• anxiety in both men and women

How Can I Know If Stress Is Impacting My Fertility?

The good news is that there is an easy, at-home test to measure how your body is handling stress. It’s called a four point cortisol test which measures your Cortisol Awakening Response (CAR).  My favorite is the DUTCH Test because it measures other hormones as well, giving a more complete picture of your health and fertility.

Here’s how it works: you spit in a tube at 4 specific times of the day – as soon as you wake up, 30 minutes after that, before dinner, and before bed. This will show how your cortisol levels change and adapt throughout the day (which is also why a blood test isn’t best practice to measure cortisol).

Typically, you want cortisol to rise sharply in the morning to wake you up and get your day off to a productive start, then peak and come down later in the day as you wind down so you can relax, fall asleep and stay asleep. 

A low or blunted CAR can be a result of:

• an underactive HPA axis
• excessive psychological burnout
• seasonal affective disorder (SAD)
• sleep apnea or poor sleep in general
• PTSD
• chronic fatigue
• chronic pain
• over exercising

A decreased CAR has also been associated with systemic hypertension, functional GI diseases, postpartum depression, and autoimmune diseases. 

An elevated CAR can be a result of: 

• an overactive HPA axis
• ongoing job-related stress (anticipatory stress for the day)
• glycemic dysregulation
• pain (e.g., waking with painful joints or a migraine)
• general depression (not SAD)

A Functional Fertility Approach to Stress and Optimizing Fertility

Has it ever worked when someone told you to “just relax and stop stressing?”

My guess is probably not. 

You can’t “just stop” when your nervous system is stuck in sympathetic overdrive.

It just doesn’t work but it will keep you spinning your wheels as anxiety remains a constant and/or worsens especially in regards to your TTC efforts.

What does work? A Whole-YOU approach to fertility optimization and that’s what Functional Fertility is all about. In our Fueling Fertility Tribe you walk through my Three Pillar Approach to Optimized Fertility which will show you how to directly:

• identify your root causes to subfertility or infertility (like identifying if you body is stuck in “no place for a baby” mode)
• heal your nervous system and bring balance to the HPA axis
• improve other root causes that impact your nervous system like gut health and environmental inputs
• begin a supplement protocol that is right for you

See you over in the tribe soon!

Citations

(1) Powell DJ, Schlotz W. Daily life stress and the cortisol awakening response: testing the anticipation hypothesis. PLoS One. 2012;7(12):e52067. doi:10.1371/journal.pone.0052067