Is my stress and mood affecting my fertility? 

Saying that the inability to conceive children is a stressful situation is an understatement for an increasing number of couples. In fact, in Canada it has been estimated that 1 in 6 couples experience this particular brand of “stress”. And how bad is this “stress”? One study found that women with infertility felt as anxious or depressed as those diagnosed with cancer or heart disease – the top two causes of death in Canada. Another study found the distress experienced to be akin to those who are grieving a significant loss. Perhaps the most troubling part is that the impact of infertility on mental health causes disruption in not just one area of life, but in all of the major dimensions: mind, body, spirit, work and relationships.

   Medicine focuses on finding an explanation for infertility. As frustrating it can be to have a diagnosis of unexplained infertility, it can be equally so to learn of one. Each period punctuates a woman’s failure, increases the disconnect from her body and fills her mind with negative chatter that erodes at her hopeful spirit. The longer the struggle with infertility, the lower the chances of conceiving. Part of this is thought to be due to the impact on the woman’s mental health. The devastation can be all encompassing. While advances in assisted reproductive technologies (e.g. IUI, IVF) may offer hope, the process has been found to exacerbate mental health conditions. This includes stress, anxiety and grief as well as feelings of the loss of self-esteem, self-confidence and a sense of control over one’s future. Furthermore, medications used to treat infertility may cause or worsen psychological distress. Clomiphene citrate (i.e. Clomid) is a common prescription to improve ovulation in fertility care, but has the side effects of anxiety, sleep disturbance, mood swings and irritability. Other medications can cause depression, mania and impaired cognition. Between the hormonal changes, medication side effects and time to ruminate (i.e. the “2-week wait”), the highs and lows of the fertility roller-coaster is enough to make anyone crazy!

   Many fertility treatment costs are out of pocket and are EXPENSIVE! Although there is some coverage by OHIP and third-party insurance, the financial burden can be limiting and very stressful. To compensate for increased expenses, many find themselves working more and resting less, which makes it hard for the body to recuperate in time for the next day’s demands.  Many who are able to pay, already find themselves in positions with heavy work loads and high stress. With less time to restore and rejuvenate, the body interprets this burden accumulation as “stress” – regardless of if it is from mental or physical means. Both male and female fertility are affected by stress. Numerous compounds within the body, such as cortisol (increased in stress) and serotonin (reduced in stress and depression), affect ovulation. Stress can reduce sperm count and leads to sexual dysfunction in 10% of male infertility cases. So in the process of working (possibly to afford fertility treatments), you may be hurting your chances of having reproductive success.

   Infertility deeply affects a women – whether they are the cause or not. It is only when there is male factor infertility, that men experience similar levels of low self-esteem and depression as their female counterparts. The “couple” may seem like an obvious relationship to suffer, but those with friends and family members are also affected. Infertility can be very isolating as it can become difficult to socialize with friends that are pregnant or be around children. The inability to express what is being felt can lead to further isolation, leading to a breakdown in communication and possibly conflict. Everyday situations can become tense and anxiety-provoking. None of these emotions put you in the mood to be intimate and can further derail a plan to have children.

   Fortunately, naturopathic medicine has the resources needed to help minimize the psychological distress associated with infertility. Counselling focused on stress management and coping-skills has been shown to be beneficial for individuals struggling to conceive. In fact, some studies suggest that addressing psychological factors such as anxiety, depression and stress, may help increase the chances of giving birth. In addition to counselling, you will learn how to improve your diet and lifestyle in ways that support your fertility and your mental wellbeing. Acupuncture can be used as a relaxation technique and encourage mindfulness, which also improves conception rates. Plus, there are a number of supplements that can encourage positive mood, improve resiliency and reduce anxiety – and are safe in pregnancy. It’s a recipe for success that addresses the mental health concerns associated with infertility from every angle.

Resources:

1. www.canada.ca/en/public-health/services/fertility/fertility.html

2. Domar, A. D., Zuttermeister, P. C., & Friedman, R. (1993). The psychological impact of infertility: a comparison with patients with other medical conditions. Journal of psychosomatic obstetrics and gynaecology, 14, 45-45.

3. Deka, P. K., & Sarma, S. (2010). Psychological aspects of infertility. BJMP, 3(3), 336.

4. Hasanpoor-Azghdy, S. B., Simbar, M., & Vedadhir, A. (2014). The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. International Journal of Reproductive BioMedicine, 12(2), 131-138.

5. Seibel, M. M., & Taymor, M. L. (1982). Emotional aspects of infertility. Fertility and sterility, 37(2), 137.