Implications & Impact of Stress
It is frequently said that stress leads to infertility. While there is no doubt that stress is associated with diminished fertility the opposite appears to be more accurate – that is, infertility leads to stress. So the old adage ‘just relax and you’ll get pregnant’ is well meaning but often misguided.
There are several ways, though, in which stress can indirectly influence fertility. It is simply that leading a busy life and all the stress that entails may leave little time for energy for a couple to actually have intercourse frequently enough to achieve pregnancy. (Of course, as you now know, intercourse doesn’t need to be frequent as long as it is well timed).
A second way is that stress itself may affect when ovulation occurs. In fact, one of the most common causes of delayed ovulation is both physiological and psychological stress. This is because stress can dramatically affect the functioning of the hypothalamus, that gland in the brain responsible for so much of the reproductive system. It is the hypothalamus that is responsible for the regulation of appetite, temperature, and most important, emotions. It is also regulates the pituitary gland, which in turn is responsible for the release of FSH and LH. When stress affects the hypothalamus, the end result can be delayed emission of these reproductive hormones, which are necessary for the release of a mature ovum. (It is not known what triggers an early ovulation, but stress does not appear to play a role).
The timing of ovulation will determine the length of the cycle – the later it occurs, the longer the cycle will be. Occasionally, if stress is severe, it can actually prevent ovulation from occurring all together. If stress were to affect your cycle, then, one of two things would probably happen.
1. You would have a longer-than average cycle, with ovulation occurring later and menstruation following day 12 to 16 days afterwards, if pregnancy did not occur
2. You would have a long cycle, but wouldn’t release an egg (an anovulatory cycle). If this were the case, the cycle could theoretically extend for months. Or you would have a long cycle followed by an anovulatory bleeding, which is the result of a drop in estrogen (as opposed to progesterone). Remember that in an ovulatory cycle, the corpus luteum dies, and the sudden drop in estrogen that usually causes the bleeding.
While it is true stress can prevent ovulation, it is my professional experience that it is more commonly delays it. For this reason, it is especially important to learn to focus on the signs that indicate approaching ovulation. That way, if stress is causing delayed ovulation, you can at least take control by identifying when you are about to ovulate, and thus take advantage of the most fertile time. Of course, the sign that indicates impending ovulation is the cervical fluid (especially eggwhite quality) that develops just before you release an egg.
One of the ironies of how stress and the desire to get pregnant can interact is that couples may inadvertently prevent pregnancy by focusing on the mythical day 14. For example, in women who usually have average length cycles, a vicious circle can develop in which the stress of continually not achieving pregnancy may only delay ovulation. This in itself wouldn’t be a problem, if the couple were taught how to identify when the woman was about to ovulate.
In women who typically have longer cycles, stress may not be delaying ovulation at all. However, if the couple is unaware of when the woman does ovulate, they may be having intercourse too early for conception to occur, thus subjecting themselves to the needless anxiety of misperceived infertility. With both examples, the most constructive advice is not to a well meaning admonition to ‘just relax’. Rather, it would be to tell them to chart their cycles, and then time their lovemaking accordingly.
Stress is also notorious for causing cervical fluid to either disappear altogether or to form patches of wetness interspersed with dryer days. It’s as if the body keeps making attempts to ovulate, but the stress continues to delay it. If this should happen, remember that the temperature will ultimately indicate when you have finally ovulated. So if you observe patches of slippery – or eggwhite quality cervical fluid, take advantage of those days until you see the confirmation that ovulation has indeed taken place by a rise in temperature.