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Stress-related reproductive dysfunctions

         When you experience a dangerous situation that scares you, your body releases a cocktail of hormones that speed up your heart rate and cause many other somatic (physical) symptoms.

While these natural responses can be helpful in a truly dangerous real-life situation, when dangers are imaginary, the feelings of fear you experience - such as stress and anxiety - can negatively impact your well-being and health. When stress and anxiety become very intense or chronic, they may have a negative impact on health and well-being, particularly on the dynamics and dysfunctions of the sexual and reproductive systems.

As the nervous system modulates the physiological functions including the sexual and reproductive system, and the brain takes into account the emotional state in all that it does, strong emotions always end up having an impact not only on behavior, but also on the proper functioning of the sexual and reproductive system, and the etiopathogenesis of all kinds of sexual and reproductive health issues.

However, it is good to know that stress and anxiety are not normative concepts, nor are they diseases in themselves. Although your stress and anxiety are not imaginary, there is no laboratory test available to confirm or measure them. Yet you feel them, and therefore you are best positioned to assess whether or not you feel stressed or anxious.

Emotions are not just mental states and emotional feelings. Today's view of emotions is that emotions are experienced at four different, but closely interrelated levels: the mental or psychological level (the brain), the physiological level (the chemistry of your body), the somatic level (bodily emotional feelings), and the behavioral level. These complementary aspects are present in all human emotions, even in the most basic ones like stress, fear, and anxiety.

The scientific study of emotion and of the bodily changes that accompany the diverse emotional experiences, known as psychosomatic medicine, marks a relatively new era in medicine. The central concept of psychosomatic medicine is the scientific fact that the mind and body are integral aspects of all human functions. The term ‘psychosomatic disorder’ is used for a physical disease that is thought to be triggered, made worse, or caused by emotional factors. To an extent, most diseases are considered psychosomatic, as there is an emotional aspect to every physical disease.

During intense stress and anxiety, there is a suppression of the gonadotropins and gonadal steroid hormones, hormones related to the disruption of the normal menstrual cycle. In addition, the stress response leads to a drop in androgen levels, and in this way contributes to temporary erectile dysfunction in men. Thus, prolonged exposure to stress and anxiety can lead to serious impairment of reproductive function.

In females, stress and anxiety can lead to anovulation, amenorrhea, and other menstrual irregularities. In males, there can be decreased sperm count, motility, and altered morphology. Various ejaculatory disorders, impotence, and oligospermia may be associated with psychological factors in male infertility. Chronic stress and anxiety can also reduce sex drive and cause women to be unable to achieve orgasm. 

Maternal stress during pregnancy has been linked to a higher risk of miscarriage, lower birth weight, and an increased incidence of premature births. Some evidence also suggests that an expectant mother's stress can even influence how her baby's brain and nervous system will react to stressful events.

As you already know, rather than passively observing what happens to you, your subconscious mind is actually in charge of the proper functioning of your conscious mind and your body through the regulatory mechanisms of your autonomous nervous system. When you feel relaxed and safe, the sympathetic branch of the autonomous nervous system kicks in and your body is nourished, and healed and energy is restored. Whenever you are facing a threat, the parasympathetic branch of the autonomous nervous system kicks in and the stress response will mobilize all your resources for your survival inbuilt fight or flight response.

While you are in the middle of a stress response, the stress response will mobilize all your resources for your survival, and your body's nourishing, restorative, maintenance and self-repair functions come to a screeching halt. Unfortunately, when the threat is imaginary, the subconscious mind doesn't realize that there is no real threat. Over time, when this stress response is repetitively triggered by imaginary threats, nature's biological response ends up doing more harm than good.

Long term, if your body is not properly nourished, restored, maintained, and repaired, the effects of chronic wear and tear on your body take its toll and you will end up mentally and physically sick. Therefore, by releasing stress and anxiety, your body creates a loop of positive feedback through the autonomic nervous system, feedback that can rebalance your sympathetic and parasympathetic branches and lead so to improvements in symptoms of your stress and anxiety-related autoimmune conditions. The degree of improvement you can reasonably expect by relieving your persistent stress and anxiety depends on how much you feel that your emotional state affects your health issues.

When dealing with a fractured bone, the standard medical approach is to align and join the broken parts of the bone and let it heal, as this ancestral approach works for everyone and every time. However, when dealing with stress and anxiety, there is no such thing as a one-size-fits-all approach. Therefore psychiatry, psychotherapy, hypnotherapy, neuro-linguistic-programming, E.F.T. (emotional freedom tapping), pet therapy, art therapy, mindfulness, yoga, craniosacral therapy, gravity blanket, mini-horses therapy, and many other approaches based on very contradictory and yet scientific concepts, are all available to solve emotional issues.

Chronic, intense, or repetitive stress and anxiety can lead to various emotional troubles and even psychiatric or physical medical conditions. According to the American Psychosomatic Society “… there is no such thing as psychosomatic disease. All disease can be looked at from this point of view”.

Here are a few of the many sexual and reproductive dysfunctions that are aggravated, triggered, or even caused by stress, trauma, and anxiety, and for which you can reasonably expect improvements when you improve your emotional health.

Stress Can Lower Your Sex Drive: "Stress, including stress from work, family or life in general, can reduce your sex drive by taking your mind off of sexual desire. Chronic stress can also interfere with your hormone levels, resulting in lower libido."

How does anxiety diminish interest in physical intimacy? “Those suffering from stress and anxiety may have reduced libidos. Stress is linked to heightened levels of the hormone cortisol, which in turn suppresses hormones that cause romantic desires. Fortunately, being more in-tune with one’s own mind and body and understanding the ways in which anxiety manifests itself can alleviate the common problem of anxiety-induced lack of interest in physical romance.”

Anxiety can lead to erection problems in young men: "There are a number of reasons why erection problems may happen, including certain health problems (such as hormonal imbalances or high blood pressure). But one of the most common causes of erection problems, particularly among young men, is anxiety.
Ordinarily, when aroused, the brain sends signals to the penis and triggers it to fill with blood. But when a person is anxious, the body releases stress hormones (called cortisol), which activates the body’s flight or fight response. Because high levels of cortisol constrict blood vessels and blood flow, this can make it difficult to get (or maintain) an erection."

Researchers see stress and trauma in women’s stories about abortion  “Our analysis indicates that stress was found to be present throughout the abortion narratives in four distinct categories: existing stressors prior to the abortion, stressors experienced while attempting to access an abortion, stressors experienced during abortion obtainment and stressors arising after the abortion.”

Couple Infertility "Stress can have a negative impact on your fertility and reproductive health in several ways. Stress seems like such an abstract term, and not long ago the entire medical profession underestimated its effect on our health.  We now know so much about the profound effects stress can have on our physiology and reproductive health.  In fact, stress is one of the leading causes of all disease.  It is likely that it has a major role to play in cases of unexplained infertility and can aggravate nearly any other reproductive health diagnosis."

Stress reduces fertility in women: The researchers found women with PSS (perceived stress scores) of at least 25 were 13 percent less likely to conceive than women with PSS scores under 10. The researchers found that, if the link between higher levels of stress and lower odds of conception is a causal association, a small proportion of that association could be due to decreased intercourse frequency and increased menstrual cycle irregularity.

Stress Can Make It Harder to Conceive: “Stress has been shown to cause reproductive problems in both men and women. In one study published in “Fertility and Sterility”, researchers tested 274 women who were trying to get pregnant and found that those with higher levels of a particular enzyme in their saliva correlated to stress had a 12% more difficult time getting knocked up.”

The Stress and Infertility Connection “We often hear that stress can contribute to fertility difficulties – some couples can try for years, with no success and it’s when they are not actively trying that somehow pregnancy occurs. Why does this happen?  What is the connection between stress and infertility? That answer is hormones! Female hormones, specifically cortisol and progesterone are the two hormones that are responsible for dealing with stress and for maintaining a healthy pregnancy, respectively. Cortisol is released from our adrenal glands when we encounter a stressful event.  Normal amounts of cortisol are imperative to help our bodies deal with stress. Progesterone is responsible for nourishing a healthy uterine lining so a fertilized egg can attach and for helping to support a developing embryo.  It is produced in higher amounts after ovulation by the corpus luteum. If the body is constantly trying to produce cortisol such as when you are under short or long term stress, then the hormone pathway is being shunted towards cortisol production and away from progesterone synthesis. Adrenaline, another hormone produced by the adrenal glands, is released during acute periods of stress and it causes the pituitary gland to release prolactin, which can have a negative impact on fertility.”

Maternal anxiety during pregnancy, early childhood linked to hyperactivity in teens “Children born to mothers with anxiety during pregnancy and a few years after birth were more likely to have hyperactivity when they were 16 years old, according to study findings presented at the European College of Neuro-psycho-pharmacology Congress.”

Stress in pregnancy linked to children with personality disorders “Mild to moderate stress while pregnant can triple the risk of children developing personality disorders by the time they're 30-years old. Researchers examined the mental health of close to 4,000 pregnant women across Finland. The study found pregnant women experiencing mild to moderate stress tripled the risk of having a child with a personality disorder. Analysts say the risk is roughly ten times greater if a pregnant woman was severely stressed adding, the stress felt by the mother is believed to impact the brain of the developing fetus.”

How Parental Stress Can Affect a Child's Health: ”Classic research has shown that children who live in stressful environments can end up with all sorts of behavioral and emotional problems at some point during development. For example, parents’ own anxiety and household stress have been linked to their children’s emotional problems, including behavior issues, aggression, anxiety, and depression (Fields et al., 2021). Maternal stress has also been linked to factors in infancy that predict later anxiety as infants get older, namely a difficult temperament or a temperament characterized by a lot of negative emotions. Further, maternal anxiety and depression are associated with children’s impulsiveness and problems with attention (Van den Bergh, et al., 2017).” 

Can Stress Cause A High-Risk Pregnancy? Here's What You Should Know. “Elevated levels of stress can be associated with elevations in blood pressure. In pregnancy, that can manifest into hypertensive disorders, which can in turn lead to things such as growth restriction during pregnancy and small birthweight babies. Preterm labor or contractions can also be associated with increased levels of stress,” she says in an email interview with Romper.”

Maternal stress during pregnancy could influence the biological clock for ageing: “The stress that some mothers experience during their pregnancies could influence the genetic makeup their babies are born with and, eventually, lead to premature biological ageing and associated age-related diseases. This is according to lead authors Tabea Send and Stephanie Witt of the Central Institute of Mental Health, University of Heidelberg in Germany.”

Stress during pregnancy affects the size of the baby: “The idea is that prenatal stress affects offspring in two different ways depending on the timing of the stressor during pregnancy—yielding different outcomes before birth, after birth, and after weaning. For example, prenatal maternal stress late in gestation causes mothers to invest less energy in their offspring, which leads to slower grow in the womb and during infancy. Once the baby has reached nutritional independence, however, they are no longer affected directly by their mother’s provisioning, and consequently grow at the same rate as non-disadvantaged offspring. Thus, maternal stress late in gestation leads to slow growth during dependent phases, but doesn’t affect growth later. By contrast, prenatal maternal stress early in gestation additionally causes the fetus to be entirely reprogrammed to deal with a reduced life expectancy. To “make the best of a bad job,” the early challenged offspring switches to an accelerated pace of life and grows and matures faster than unchallenged offspring to ensure that it reproduces before it dies. Once set on the fast track, the offspring under early prenatal maternal stress remain on this trajectory even after weaning and therefore overshoot the usual body size for age throughout development.”

Prolonged stress can impact quality of sperm, study says. “Prolonged stress, such as that experienced during military conflict, can have an adverse impact on sperm quality, according to a new study by researchers at Ben-Gurion University of the Negev (BGU) and Soroka University Medical Center in Beer-Sheva, Israel. The study, which was just presented at the International Summit on Assisted Reproduction and Genetics in Israel, indicated that more than a third (37 percent) of the sperm samples taken during a stressful period were found to have low sperm motility.”

Fathers' stress may have a surprising impact on their children's brain development: ”Researchers at the University of Maryland School of Medicine, led by neuroscientist Tracy Bale, found that a father's stress level could affect the brain development of his offspring. The study found that changes occur prior to conception, as the stress changes the makeup of the father's sperm, according to The Sunday Times. Bale and her team found that even mild changes can greatly impact the development and potentially the health of future offspring.”

How stress echoes down the generations “Changes to sperm may transmit epigenetic changes to children. The effects of child abuse can last a lifetime. Neglected or abused children have a higher risk of developing all sorts of ailments as adults, including mental illnesses such as depression but also physical ones like cancer and stroke. In fact, the effects may last even longer. Emerging evidence suggests that the consequences of mistreatment in childhood may persist down the generations, affecting a victim’s children or grand-children, even if they have experienced no abuse themselves.”

Stress can lower a woman's fertility ? "New research seems to confirm that stress lowers a woman's chances of becoming pregnant, particularly stress that occurs around the time of ovulation. If you are feeling more stress than you usually do [around ovulation time], you are 40 percent less likely to get pregnant that month," said study author Kira Taylor. She is an assistant professor of epidemiology and population health at the University of Louisville School of Public Health and Information Sciences."

Can Anxiety Keep You From Getting Pregnant ? "A recent peer-reviewed study in Nature Reviews: Urology found that it does affect male fertility. (Plot twist.) The research suggested that "stress is associated with reduced paternity and abnormal semen parameters." In layman's terms, their research concluded that the hormonal components of anxiety in males negatively affects the hormones that produce semen, making the male experiencing the anxiety less fertile."

Vicious cycle of stress and infertility  "There have been controversies from a long time about whether stress can cause infertility or infertility causes stress. A research conducted in the US stated that stress causes infertility in women. Infertility is a term used to explain the inability of a woman to conceive after two years of constant efforts, whereas the term stress is probably the most used word in today’s world. We can say that both stress and infertility are co-related. When diagnosed with infertility, many couples feel helpless and no longer in control of their bodies or their life plan. They become stressed. On the other hand, men who work in night shifts are more likely to be infertile, compared to men who work in morning shifts as their biological clock is immensely disturbed. They sleep during the day and to keep themselves awake, they often smoke, which damages the system further. Stress at workplace and sitting for long hours at work stations is also found to reduce the sperm count."

Daily stress can kill your sex life "Regular stress can not just hamper your peace of mind, affect sleep and weaken your immunity, but prolonged periods of high stress and anxiety, can increase blood pressure and cholesterol levels, leading to erectile dysfunction (ED) which will hamper your sex life, experts have warned. ED is an inability to develop or maintain an erection during the sexual activity. It can have severe psychological consequences as it can limit your intimacy, affect your self-esteem and impact your most important relationship."

Diminished sex drive "Another thing to go when you're under the gun from stress is your desire for sex. Increased stress over long periods of time means an increase of cortisol in your system, which eventually suppresses the hormones that would normally make you horny. Sure, sex might help you feel better, but if you don't feel like having sex there's no benefit. I mean, who has the psychic space to think of pleasure when money problems, relationship drama, or work issues are on your mind 24/7"

How stress affects your sex life: Of all the natural libido killers out there, arguably none is more sinister than stress. It is a hidden demon, one that lurks over us, seemingly unable to be controlled. We have busy lives, deadlines, partners, families, and a million other things to worry about. Sex just doesn’t feel appetizing right now.

Stress Can Make It Harder for Men to Have an Erection: “Erectile dysfunction is complicated and can have physical as well as psychological causes. Science, however, has shown over and over that stress tends to make the condition worse by releasing more adrenaline and causing exaggerated contractions of the muscles in the penis, keeping it from filling with blood.”

Erectile Dysfunction (ED, Impotence): "Anxiety plays a major role in the development of the problems associated with erectile dysfunction (ED). Psychological and behavioural responses to ED can lead to a vicious cycle of increased uneasiness, distance and conflicts. This in turn leads to a lower frequency of sexual encounters, less time spent together and lack of communication between partners in a relationship."

Hypersexual disorder, or an overactive sex drive, normally entails obsessive thoughts of sex, a compulsion to perform sexual acts, a loss of control, or sexual habits that carry potential problems or risks. New research from Karolinska Institutet in Sweden shows that hypersexual disorder – known popularly as sex addiction – can be linked to hyperactive stress systems. In a stress regulation test using the cortisone drug dexamethasone, men with hypersexual disorder showed higher levels of stress hormones than controls, a finding that the researchers hope will contribute to improved therapy for this patient group.