Psychologists usually define stress as a form of psychological and behavioural interaction between people and their environment, i.e. the person responds to what is happening to them and around them.
There are essentially two types of stress – acute stress and chronic stress. Acute stress is a response to an immediate threat, such as an exam or public speaking. Chronic stress is a response to more prolonged or frequent, situations such as work pressures or unemployment.
The effects of stress can be beneficial and enable the ‘fight or flight response’ to help us escape from a perceived dangerous, or harmful, situation. However, the effects of stress can also be harmful by mediating a series of physical changes and responses in the body. Negative consequences of these stress responses can impair our thinking, metabolism, immune function and, potentially, even reproduction.
Primary infertility is the term used when a couple have never conceived and is usually diagnosed after a year of sexual intercourse without contraception. Secondary infertility is the term used when there has been at least one prior conception, even if the pregnancy wasn’t carried to term. Other common infertility problems include early pregnancy loss and recurrent miscarriage. There are many known biological causes of fertility problems but some remain ‘unexplained’. Fertility problems are very common worldwide and are estimated to affect over 24 million women.
Fertility and stress: what the research says
There has been huge debate over the years about whether a link really exists between stress and fertility issues. Numerous studies over the years have found an adverse impact of stress on women’s reproductive health. Stress has been implicated in everything from causing premenstrual pain, loss of sex drive, sexual problems, absent periods to infertility, miscarriage, still birth and low birth weight in babies.
Most women have probably experienced their periods becoming irregular – or maybe even disappearing altogether during times of stress. Anovulation (not ovulating) is a medically recognised consequence of high-level stress. Equally, women who lose a great deal of weight due to stress may also find that their periods become irregular.
The general day-to-day stress of modern-day life can negatively impact couples’ sex lives and if partners are just too tired, or too unhappy, after a stressful day to have sex – or if they are only having sex infrequently – then that is also going to reduce the chances of having a baby!
The stress connection
A link between psychological stress and reduced pregnancy rates has been highlighted. For example, one study found that high stress levels were associated with poor responses to fertility treatments and lower pregnancy rates. Another study of women who planned their first pregnancies, found that women with higher stress scores had lower pregnancy rates and higher early miscarriage rates than those with lower stress scores. Scientists have also found that, both in rats and in humans, stress can induce repeated miscarriage by negatively impacting small protein and cell changes. In women with recurrent miscarriage, some research findings have indicated that high stress levels are associated with an increased risk of subsequent pregnancy loss.
In one of the most recent studies, released in March of this year, American scientists from Ohio State University studied an enzyme found in saliva that provides a biomarker of stress. They found that for women with high levels of this biomarker were 29% less likely to get pregnant each month and doubled their chances of infertility.
So, based on some of this evidence, it does appear that stress plays a significant role in fertility problems but doctors, psychologists, scientists and researchers remain very much divided on the issue. There are an equally abundant number of scientific studies showing that stress is merely a side effect of fertility problems and not the central cause. The bottom line for the majority of health professionals working in, and researching, this area is that infertility is largely a medical problem and not a psychological one.
For millions of people, trying to conceive a child brings cycles of hope as well as misery. Fertility problems can turn life into an emotional roller coaster affecting how people see themselves, their sex life, their relationship with their partner and their relationships with other people. Without doubt, the vast majority of individuals and couples that I see are suffering from some form of fertility-related stress. Many feel that they are no longer in control of their bodies or their life plans. Fertility investigations and treatments can also be physically, emotionally and financially very stressful.
However, attempting to reduce stress by giving up a job or suddenly and dramatically changing your lifestyle isn’t particularly recommended except in very extreme cases. There are many stress reduction techniques which may be helpful such as mindfulness, meditation, yoga, reflexology or acupuncture. Excessive caffeine and other stimulants such as alcohol should be avoided and regular exercise should be a normal, and important, part of your routine.
Therapy can help
Counselling is, unfortunately, very often viewed as the last ditch effort in fertility-related stress but in reality it is simply a better way of understanding fertility problems and their effects. Counselling can help individuals to develop better coping mechanisms, boost emotional reserves and facilitate couples in communicating more effectively.
Remember, a certain amount of stress is normal and whilst the link between stress and fertility does remain unclear it will only ever benefit our overall wellbeing to reduce stress levels as much as we possibly can. If high levels of stress continue for a long period of time, consider seeking professional help or talk to your GP about your concerns.
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