‘Just relax and it’ll happen’ – Fertility, Stress and the Hormone Party
If you’re trying to conceive, you’ve no doubt heard this joyful little phrase from well-meaning friends or family. Is there anything more annoying? Whilst relaxation alone may not help you to conceive, if you’ve been struggling for a while, it’s worth understanding a little more about the complex interplay of hormones within a woman’s body, how these can be massively impacted by stress, and how this can impact on your reproductive health and wellbeing. Just as a heads-up, it’s proven to be pretty tricky to explain some of this without getting a bit geeky with the jargon, but I’ve done my best to keep it simple (as this helps me too!). So, in this week’s blog I’ll try to explain what happens in a woman’s body when we’re stressed and how this may be a part of your fertility jigsaw puzzle which you can start to influence (NB: I know stress affects men too, and lots of other factors influence fertility health, but they’re topics for another blog on another day!).
As someone who was highly stressed pretty much throughout my whole journey to conception, I do understand how difficult it can be to get those feelings under control at such a naturally emotive time. But, maybe if I’d fully understood the impact that stress was having on my body at that time, perhaps I may have been more proactive in trying to address those stressors, rather than fuelling them further by endless googling, comparisons and continual absorption of all things fertility related. I was obsessed. I think if someone had fully explained these impacts and offered me a toolbox of strategies to help keep my stress in check as much as possible (enabling me to focus on my life that was still going on while I was trying to conceive), this may have helped me. I really hope that this brief overview, in some small way, can help you, or someone you know, who is going through this horrible time right now.
‘The interplay of reproductive hormones in the woman’s body is essential for fertility – without them, in the right balance and at the right times, ovulation, fertilization, implantation, conception and ongoing pregnancy simply cannot occur’
(Barbara Scott, Reflexology for Fertility).
There’s a hormonal party going on in your body every single day and it’s a pretty fine line between everything ticking along nicely (think just a few close friends hanging out together, relaxing and having a good time) and things getting way out of control (think gatecrashers, breakages & hangovers). If there’s a hormonal imbalance, this can have a huge impact on your chances of conception. So, let’s take a closer look at the main guests at this hormonal party and what it takes for that balance to start to be tipped.
Follicle Stimulating Hormone (FSH) is produced by the pituitary gland (in the brain) which helps stimulate levels of Oestrogen. Oestrogen is a sex hormone which has a crucial role to play in the run-up to conception; it helps prepare the womb environment, shifts the cervix & fallopian tube positions, changes cervical mucous & supports the body to release endorphins, helping to increase energy. It also stimulates the hypothalamus in the brain to release Gonadotropin-releasing Hormone (GnRH), which stimulates the pituitary to release FSH (which at this time stimulates the ovaries to release an egg) & Luteinising Hormone (LH) (which helps the thickening of the uterine lining ready for an embryo to implant). All this activity is therefore optimising the conditions for intercourse, supporting the eggs to mature and encouraging ovulation to take place.
After ovulation, Progesterone really starts getting involved in this party. Following ovulation, the ruptured follicle develops into the Corpus Luteum, which secretes progesterone. This then works alongside oestrogen to encourage blood flow to the uterus, encouraging the lining to thicken to support implantation and help maintain a pregnancy. It’s also responsible for changes to breast tenderness, digestion, cervical mucous & body temperature.
So, if all conditions are right and these hormones are behaving well and are well balanced (and there are no other factors at play), well timed intercourse (pre-ovulation) may then set the wheels in motion for conception and ongoing pregnancy to occur.
What can go wrong to turn this hormonal party sour?
Our hormones can be affected by many things (which is yet another blog for another day!), but today I’ll be explaining the impact of stress. Let’s start with what stress is – ‘a state of mental or emotional strain or tension resulting from adverse or demanding circumstances’ (Oxford English Dictionary). It’s no surprise then that fertility challenges and stress go hand in hand.
Firstly, just to set the scene a little, our bodies are designed to deal with stress. Think of primitive woman – she needed the ability to ‘fight’ or ‘flee’ when under attack and her body would respond with hormonal surges and bodily changes to help her to do this effectively. In this scenario, when we’re under short bursts of stress, the HPA axis (between the Hypothalamus & Pituitary in our brain and our Adrenals) is activated and we’re able to cope pretty well as a result. Once the danger (or perceived danger) has gone, part of our brain kicks in to counteract the hormonal fluctuations the stress caused and restores homeostasis (balance). The problem comes when the stress is prolonged as this disrupts the body’s ability to recalibrate, impacting on another axis which controls our reproductive system – the HPG axis; the Hypothalamus – Pituitary – Gonadal (reproductive organs).
This is when a chain of hormonal reactions starts and Cortisol, Adrenaline & Noradrenaline begin to be released (which research has shown can inhibit reproduction). Firstly, the body becomes really focussed on producing Cortisol in times of stress. This in turn increases the level of sugar and fat in our blood ready to ‘fight or flee’ and as a result, impacts on bodily functions such as digestion and immune response, increases our inflammatory response and suppresses reproductive systems. In addition, adrenaline & noradrenaline kick in, which are hormones which constrict our blood vessels, increase our heart rate and blood pumping around our body, essentially putting us on high alert ready to run! So, when we’re stressed, our blood is diverted to our muscles and away from our reproductive system which has all sorts of potential repercussions.
So, what’s the potential impact on fertility?
Raised cortisol levels impact on the release of key hormones including GnRH and therefore LH, FSH, testosterone and oestradiol (oestrogen). This could then have an impact at any stage of the process, impacting on the release of the egg, the thickening of the uterine lining etc.
So, given all this, it’s no surprise that our reproductive health can be affected as oxygen is diverted to where it’s needed most when we’re under stress (namely the brain and our muscles). Why would hormonal changes involved in ovulation and a supporting a regular, healthy menstrual cycle be prioritised when our body is working so hard to simply carry out basic functions to keep us safe? As well as the potential impact on cycle regularity and ovulation, chronic stress levels could also affect the development of the Corpus Luteum (& therefore the production of progesterone). Given that the Corpus Luteum derives from the ruptured follicle at ovulation, and that that follicle took 100 days to move from its dormant state to become dominant at ovulation, you can start to see the potential impacts are not just in the here and now.
In this context, we can see that whilst stress is unlikely to be the only factor at play if you’re struggling to conceive, it could be a (small or large) part of the jigsaw puzzle. If you feel your stress levels are regularly higher than you’d like them to be, are there any small, achievable steps you could take to start to redress the balance? At this really challenging time, being kind to yourself is really important, and every little step counts (afterall, the last thing you need is another list of things you feel you should be doing on top of everything adding further stress to your plate). Just try to be kind to yourself above everything else. Take that long bath, go for that walk in the country park, spend time with friends who make you happy, or absorb yourself in doing something you love little and often. Know that every time you do so, you’re giving your body a helping hand to be in balance.
If you’d like to discover more about how fertility reflexology may support you to reduce your stress levels & support hormonal balancing, follow the link below or please don’t hesitate to contact me for more info.
Joseph, D.N, et al. (2017) Stress and the HPA Axis: Balancing Homeostasis and Fertility. International Journal Molecular Science.
G.M. Buck Louis, K.J. Lum, M.S. Rajeshwari Sundaram, Z. Chen, S. Kim, C.D. Lynch, E.F. Schisterman, C. Pyper (2010) Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. In fertility and Sterility Vol 95, No 7, pp 2184-2189.
Moberg, G.P. (1987) Influence of the adrenal axis upon the gonads. In Clarke, J.R, (eg), Oxford Reviews of Reproductive Biology, Vol. 9. Clarendon Press, Oxford, pp 456-496.
S.L. Berga, T.L. Davies and D.E. Giles (1997) Women with functional hypothalamic amenorrhea but not other forms of anovulation display amplified cortisol concentrations. In Fertility and Sterility Vol 67 No. 6, pp 1024 – 1030
M.D. Marcus, T.L. Loucks, S.L. Berga (2001) Psychological correlates of functional hypothalamic amenorrhea. In Fertility and Sterility Vol 76 No. 2, pp 310 – 316.
K.A. Sanders and N.W. Bruce (1997) A prospective study of psychosocial stress and fertility. In Human Reproduction Vol 12 No. 10, pp 2324 – 2329
E.D. Kirby, A.C. Geraghty, T. Ubuka, G.E. Bentley and D. Kaufer (2009) Stress increases putative gonadotrophin inhibitory hormone and decreases luteinizing hormone in male rates. In PNAS Vol 106 No. 27, pp11324 – 11329
Barbara Scott (2016) Reflexology for Fertility
Sally Earlam (2015) Reflexology: supporting your client through the conception and maternity journey (Association of Reflexologists) ed0