Can Stress affect your Fertility?
Amenorrhea is defined as the absence of menstrual cycles, and it can be classified as primary or secondary amenorrhea. Primary amenorrhea is when a woman is unable to have her menses by the age of 16 (or two years after the onset of puberty) or she does not go through puberty by the age of 14. Secondary amenorrhea occurs when a woman stops having her menses after they had already begun.
Amenorrhea can be the result of many processes. The first and foremost reason for having secondary amenorrhea is pregnancy. So the first thing to do if you are experiencing amenorrhea is to check if you are pregnant. However, there are many other things to consider when determining the root cause of secondary amenorrhea. There could be a structural problem within the reproductive tract, there may be an abnormality with the proper functioning of the thyroid gland, or there might be another type of hormonal imbalance (ie Polycystic ovarian syndrome and abnormal pituitary secretions). There are many other causes, including: drug abuse, physical trauma to the brain, chemotherapy, autoimmune conditions, mumps, and emotional stress. Emotional stress is very important because it is something that everyone can experience to a varying degree.
Stress can manifest in our lives in a variety of forms: grief, anger, worry, sadness, working too much, excessive physical exercise, malnutrition, and many other forms. But what do they all have in common? They can influence the hormonal balance between the hypothalamus, the pituitary, and the ovaries.
From a Western perspective, we know that times of stress can cause a release in corticosteroid Releasing Hormone (CRH) from the hypothalamus and catecholamines (stress hormones) from the adrenal glands. Both of these together suppress the release of Gonadotropin Releasing Hormone (GRH) from the hypothalamus, luteinizing hormone from the pituitary gland, and estrogen and progesterone from the ovaries (all of these hormones help maintain regular periods). This can cause your periods to come to a full stop, and is known as secondary amenorrhea from functional hypothalamic dysfunction.
Chinese Medicine offers a very wise perspective on this connection. The Heart is believed to be connected to the Uterus by an energetic vessel, called the Uterus Vessel. When emotional stress upsets the balance of the Heart Qi (energy), the blood is unable to descend from the heart through the vessel to reach the Uterus, causing a cessation of the menstrual cycle.
So what can you do to prevent stress from messing with your cycle?
1. Yoga and Meditation: these are two of my favourite tools when it comes to dealing with stress. I believe that they are both incredibly powerful tools to increase your resistance to the daily stress in your life. They can help address and resolve emotions of anger, worry, anxiety, sadness, and grief.
2. Healthy Diet: eating healthy and nutritious meals with sufficient amounts of protein and iron. You want to make sure that you are eating foods with real nutritional value and try to avoid too many greasy and dairy-based foods (in Chinese Medicine foods with these qualities are believed to cause problems with menstruation in some cases).
3. Sleep: making sure that you are getting good quality sleep for at least 7-8 hours a night.
4. Physical activity: avoiding excessive physical labour or exercise. But a healthy amount of exercise will actually be beneficial for your overall health and probably help increase your resilience to stress.
5. Relax: taking breaks from work and not becoming a Workaholic.
Reducing stress can help prevent dysfunction of the hormonal balance between the hypothalamus, the pituitary, the adrenals, and the ovaries, and therefore it may help prevent amenorrhea that can result from stress. However, if you are a woman of reproductive age that has amenorrhea for 3 months or more and you are not pregnant, you should seek medical attention.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about Infertility should speak with their Naturopathic Doctor or Family Physician.
1. Giovanni, M. (2011). Obstetrics and gynecology in Chinese medicine. (2nd ed.). Elsevier.
2. Chrousos, G., Torpy, D., & Gold, P. (1998). Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: Clinical implications. Ann Intern Med, 129(3), 229-40.