Birth Pangs

Prolonged stress can mess up your fertility, says new research

Her mother’s death two years ago had hurled Shelly Jain into the pits of depression. She started smoking a lot, skipping meals and overworking herself. The result—her periods became irregular and the 32-year-old had difficulty in conceiving. When she went to the gynaecologist, she was told that stress had taken toll on her fertility.

“I had always worked for at least 12 hours a day and was used to dealing with stress. But my mother’s death was too much to take,” she says. After several therapy sessions with a gynaecologist and a less pun-ishing work schedule, Jain conceived twins.

That stress can trigger a host of diseases has been well documented but in acute cases it can also affect fertility. A study in The Journal of Clinical Endocrinology & Metabolism, for example, found that women who did not ovulate had excessive levels of cortisol, a hormone secreted by the body when one is stressed, in their brain fluid.

“It is only when you are under a lot of stress for a prolonged period of time that your body starts reacting in a negative way,” says Dr Geeta Chadha, senior consultant, gynaecology and obstetrics, Indraprastha Apollo Hospitals. “It is important to find a balance between work and leisure. If you’re working a lot on a particular day, make sure to take some time to relax the next day. Our bodies are designed to deal with minor stress,” says Dr Aneja.

Many people deal with stress by altering food habits. Eating disorders such as anorexia and bulimia also affect a woman’s fertility. Many women who suffer from anorexia stop menstruating due to extreme weight loss. “A woman needs body fat in order to menstruate, become pregnant and give birth to a healthy baby,” says Dr Chadha. When a woman’s percentage of body fat falls below a certain minimum, the body stops producing the levels of hormones that are required to stimulate ovulation. Even if a woman who suffers from an eating disorder gets pregnant, it will be difficult to carry the pregnancy to its full term. “As a feotus develops it takes nutrition from the mother. If the mother doesn’t have enough nutrition she may run a high risk of a miscarriage,” says Dr Chadha. However, most of the anorexic women, who successfully treat their disorder, can regain their ability to conceive.

Cigarette smoking, too, has a negative impact on fertility. “I have patients who smoke to deal with stress during work. Cigarette smoking strongly contributes to infertility in both men and women. The prevalence of infertility is higher and the time it takes to conceive is longer in smokers as compared to non-smokers,” says Dr Aneja. Moreover, research indicates that passive smoking is only a little less harmful as compared to active smoking.

The way out to deal with the condition is a combination of therapy and drugs. A research published in the journal Fertility and Sterility showed ovulation was restored in seven of eight women who underwent cognitive behavioral therapy, compared with two of eight who did not get therapy.

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“Before we prescribe any kind of drugs to the patient we make them u dergo cognitive behavioural therapy—this is a simple therapy session between the doctors and the patient who is trying to get pregnant,” says Dr Anjila Aneja, senior consultant, Fortis La Femme Hospital. “The patient’s input is important for us as it tries to make us understand what is triggering the stress. Once we know what the problem is we prescribe drugs if required. Sometimes, we also tell them to do some relaxation exercises,” she adds.