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Physiological stress: A direct cause for infertility
Posted in Health, Research, Stress - 0 Comments

depressive disorder affects pregnancy

Women’s fertility has been a strong area of medicine and research as society’s pressure on childbearing has stood strong throughout time. The ovulation cycle is anything but simple due to the extensive physiological systems that closely regulate a wide array of hormones. Recently, a study published in Adaptive Human Behavior and Physiology revealed that an increase in physiological stress has had a profound effect on estradiol, one of the hormones responsible for ovulation and fertility.

Hormones, stress and fertility

Cortisol is the primary hormone released under physiological stress and, although cortisol and estradiol are very different in function, they both are produced via the hypothalamus-pituitary axis, which acts to regulate peripheral organs in the body such as the ovaries and adrenal glands.

Estradiol is a form of estrogen released from the ovaries in the first phase of menstruation known as the proliferative phase. Estradiol works to build up follicles in the ovary which eventually mature into an egg (ovum) that is released at ovulation. The ovum when fertilized by a sperm in the second phase of the menstrual cycle, known as the luteal phase, will eventually become an embryo and implant itself in the uterus. Cortisol, on the other hand, is released by the adrenal glands in response to physiological stressful situations. Although cortisol does not directly play a role in follicle development in the menstrual cycle, it has been shown to have an inhibitory effect on estradiol itself.

The hypothalamic-pituitary axis is located in the brain and is responsible for the initial control of hormone regulation. Adrenal corticotrophin releasing hormone (ACTH) and follicular stimulating hormone (FSH) are both released from the anterior pituitary, which is directly regulated by the hypothalamus. FSH acts directly on the ovary to release estradiol, whereas ACTH works directly on the adrenal glands to release cortisol.

Fertility is not only regulated by estradiol but also by the hormone progesterone. Progesterone is similar to estradiol in the sense that it is needed in order to conceive. However, progesterone is primarily released in the second phase of the menstrual cycle, known as the luteal phase. The luteal phase is responsible for the proliferation of the endometrial lining in preparation for embryo implantation. If implantation does not occur either due to hormonal dysregulation, contraceptive barriers or abstinence, then the uterine lining is shed, resulting in menstruation. There are a multitude of steps that can go awry, resulting in infertility. Not enough estrogen or progesterone is a common reason for infertility.

Controlling stress for personal health

In a society where we are constantly under physiological stress, resulting in an increase in cortisol, it may explain why infertility rates are on the rise. According to the study mentioned above, “perceived stress could affect estradiol production through various mediating pathways. Cortisol has been shown to have inhibitory effects on the hypothalamic-pituitary-gonadal (HPG) axis and is known to be released in response to psychological stress, such that effects of perceived stress on estradiol may have been mediated by cortisol.”

Although there are no current studies indicating that lowering stress levels and cortisol will improve fertility due to an increase in estradiol, it is known that a high level of stress can have detrimental effects on the body and mind, in general resulting in anxiety or depression. Finding a balance between enough stress to be productive but not so much that it can hinder the mind and body may be one of the most difficult balancing acts in daily life. However it is vitally important in order to invest in one’s personal health and long-term wellness.

Sovereign Health of Arizona provides females in need with effective and comprehensive treatment for problems including mental disorders caused by extreme stress along with treatment for addiction, trauma and co-occurring conditions. If you or your loved one is struggling with a mental disorder, please contact us through our 24/7 helpline. We are here for you.

About the author

Kristen Fuller, M.D., is a medical writer at Sovereign Health and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author who also teaches, practices medicine in the urgent care setting and contributes to medical board education. She is an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at



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