Infertility Stress
Infertility Stress: An Overview — What Is Stress?
Stress is one of the most over-used and poorly understood words in our vocabulary. Stress in its widest sense is defined as any event that a person perceives as threatening. When a person perceives such a threat, the body responds with the classic “fight or flight” response to protect itself. This “fight or flight” response originated eons ago as a critical tool for survival, when threats were typically direct and required an immediate reaction, like an attack by a predator. However, stress can come from just about anything that a person feels is threatening or harmful. Stress might be generated by a single event, or by the cumulative power of any number of small worries that abound in our current modern lives. Even the worry that we feel about a stress can, itself, be a source of stress. Stressors that arise these days include internal stress such as the inability to achieve what we set out to do, or external stress arising from pressure applied by family, coworkers or even strangers in the grocery line. Some forms of stress are within our control (we can avoid the long grocery line), while others are not (we can’t escape all of our obligations at work or at home).
Stress may also be acute or chronic. Under acute stress, a person’s heart beat faster, his blood pressure rises, he breathes harder, his skin becomes cool and clammy and he may sweat. Under chronic stress, a person might develop depression, changes in sleep habits, and a reduced ability to fight off illness.
The biological cause of these stress symptoms is as follows. When a stress trigger is present, the hypothalamus produces a hormone called corticotropin releasing factor (CRF). CRF activates the hypothalamic-pituitary-adrenal (HPA) system, causing it to release neurotransmitters called catecholamines, as well as cortisol, the primary stress hormone.
Why is Understanding Stress Important for People Dealing with infertility?
Couples undergoing treatment for infertility will experience stress. In fact, some studies indicate that many women who are being treated for infertility have as much stress as women who have cancer or heart disease. The stress felt by an infertile couple changes in form over the course of each month – from pressure to perform sexually when the woman is ovulating, then to from hope that the woman is pregnant, and finally to disappointment if she is not.
While there is little doubt that infertility causes considerable stress, the question whether stress can cause infertility remains controversial. No clinical studies have demonstrated clear evidence that stress causes infertility. Anecdotally, some women who exhibit considerable stress also have changes in hormone levels that affect ovulation, but this may not be true of all women. Stress could interfere with pregnancy through direct hormonal effects, or indirectly by impairing a couple’s capacity to have effective sexual intercourse or to follow the complex instructions and sexual prescriptions involved in medical treatment.
Regardless of the clinical evidence, many couples themselves will begin to believe that it is the stress they are experiencing which is prohibiting them from becoming pregnant. That feeling that stress and/or the inability to manage it well (to be a “trooper”) is contributing to a couple’s fertility problem is increasingly prevalent because of new thinking about the mind-body connection, including some unfounded but hard to dislodge beliefs that even patients with cancer can cure themselves by the power of positive thinking. Whenever a fertility treatment fails, it is easy to believe it was because the patient was “too tense.” It’s no big surprise that that kind of pressure only increases stress. Therefore stress and infertility end up in a circular relationship. Infertile couples, who are under stress because of their infertility, start blaming themselves for their infertility. This increases their stress levels and potentially further aggravates hormonal changes, sexual dysfunctions and other possible ways in which stress might be contributing to the fertility problem. For these reasons, it’s important to consider stress-reduction as a necessary part of any program or protocol for treating infertility.
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