When infertility can’t be linked directly to genetics, a reproductive health condition like polycystic ovarian syndrome or endometriosis, or pelvic inflammatory disease, doctors often label it as “unexplained infertility.” Naturally, this doesn’t give women who are unable to conceive much hope. When something has no explanation, there’s no root cause to address and the problems perpetuate with no clear solution in sight. Some studies, however, have explored the potential link between stress and unexplained fertility, particularly when the stress is a psychological result of a traumatic event. As defined by the U.S. Department of Veteran Affairs, post-traumatic stress disorder, or PTSD, “is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.”
That definition gives a good starting point but there’s another side to PTSD that many people are unaware of: infertility-related PTSD. There’s a clear catch-22 here. Post-traumatic stress disorder can both be the cause of and a result of long-term infertility. In order to better understand the correlation between PTSD and stress-related infertility, let’s take a deeper look.
The mind-body connection: how does psychological stress affect the body?
We all have some level of stress in our lives and not all stress is inherently “bad.” In fact, a healthy level of stress can help you become mentally stronger and more resilient. But when stress becomes chronic — or lasts for an extended period of time — it can wear on both your mind and your body.
Stress starts in the hypothalamus, a tiny region in the brain responsible for the production of many of the body’s essential hormones. It controls everything from your body temperature to your sex drive to how well you can sleep. When you become stressed, your brain releases adrenaline and cortisol. While this is meant to promote the “fight or flight” response needed to handle certain stressful situations, too much can wreak havoc on your mind and your body.
Cortisol is the primary stress hormone and the one that can cause the most damage, especially if levels remain too high for too long. Essentially, cortisol stops bodily functions that are “nonessential” to responding to a stressful, potentially dangerous situation; your immune, digestive, nervous, endocrine, cardiovascular and reproductive systems all take a hit.
When you’re in a situation that actually requires a quick, fight or flight response, this is useful. However, in day to day life, it’s not likely that you’ll need this intense reaction. Still, many people experience chronic stress to the point that their entire body begins shutting down. There are many reasons people develop chronic stress, including:
- The stress of poverty
- Being in an unhappy relationship or part of a dysfunctional family
- Career-related stress
- The stress of infertility
- Past traumatic experiences
Chronic stress, whether due to PTSD or other life events, can be controlled. The real problem comes when people get so accustomed to their stress that they don’t seek treatment. The body and mind are inextricably connected, so when stress becomes your default state, your entire life can be impacted.
How does infertility cause PTSD?
It’s clear that stress can cause infertility — high levels of cortisol impact the body’s ability to function properly, including the reproductive system. So how does infertility and all the related struggles cause post-traumatic stress disorder? There’s no definitive answer to this but studies are being done to understand how the two are related.
Research done by the Harvard Medical School explored the theory that the emotional and financial toll of infertility and subsequent infertility treatments can cause chronic stress and, in some people, PTSD.
This is due to a combination of factors, including financial worries, relationship stress, the side effects of hormones used to treat infertility, and the outcome of fertility treatments. All of these stressors add up and, over time, can lead to PTSD or, at the least, chronic stress. Specifically, post-traumatic stress disorder can be primarily linked to the outcome of fertility treatments — whether that’s the stress of becoming parents after grueling fertility treatments or the grief and stress that comes from failed treatments.
What are the effects of PTSD on fertility?
Unfortunately, extensive research hasn’t been done on how infertility can cause PTSD. We do know, however, the ways in which PTSD or chronic stress can impact fertility. As noted above, excessive levels of cortisol can cause all non-essential bodily functions to shut down, including the reproductive system in both males and females. Basically, when stress takes over, the other hormones in the body become out of balance.
In the female body, hormonal imbalances due to stress can cause menstruation to become irregular or stop entirely and cause mood swings and decreased sexual desire. These are just symptoms, though. Chronic stress and PTSD are generally long-lasting and, over time, can affect estrogen production, the health of the ovaries, the eggs, and the body’s ability to become pregnant and then sustain that pregnancy.
How PTSD affects the male reproductive system
Just as chronic stress and PTSD can diminish a woman’s estrogen production, men can experience a sharp decline in testosterone — the key male reproductive hormone. This can, in turn, cause erectile dysfunction, impotence, and decrease the quality, quantity, and motility of the sperm. One study followed men who were receiving fertility treatments; some of them had been diagnosed with PTSD and some did not have severe psychological stress. They found that “sperm motility showed a significant reduction in cases of PTSD and...had more abnormal forms of spermatozoa in the ejaculate than those without PTSD.”
How to deal with PTSD and chronic stress while trying to conceive
If you think you have PTSD or another form of chronic stress, the most important thing you can do is talk to your doctor. The sooner the better when you’re trying to get pregnant. Not only will your doctor be able to potentially provide medication that can help control your stress, they’re also likely to refer you to a mental health specialist who can give you the coping skills you need to work through PTSD.
Though none of these options should replace seeking professional help, you can also learn to manage your stress through meditation and yoga. These can and should be incorporated into your life, alongside treatment from a psychologist and, if need be, a psychologist.
Remember: you’re not alone. Millions of men and women in the U.S. and beyond share your struggle — both with infertility as a result of PTSD and PTSD as a result of infertility. Creating a support system around you can help you learn to cope, so you can take back control of your mind and your body.