How Does Stress Affect Fertility?

How Does Stress Affect Fertility?

7 min read

Stress is a normal part of life; our bodies were designed to handle acute stress. But, when that stress gets to be too frequent or too lengthy, things don’t go according to design and stress can start to have an impact on everything from sleep to skin to health to, you guessed it, even fertility. Here’s what you need to know about how stress can affect your reproductive health.

What happens when we get stressed?

When faced with a stressful situation we experience a short alarm phase which tells your brain to activate your sympathetic nervous system—your fight or flight response. This sets off the release of adrenaline and a stress hormone called, alpha-amylase. Perceived stress also activates the hypothalamic-pituitary-adrenal pathway (also called the HPA axis) where signals are sent from the glands under your brain to your adrenal glands, telling them to release a bunch of cortisol (another stress hormone).

Okay, so you’ve been walloped by something (emotionally, mentally, physically), your brain has sent out the orders, and now you’ve got cell signals and hormones dispatched to help you cope. Energy gets shunted away from digestion and reallocated to your muscles. Your pupils dilate to help you see more. Your heart rate becomes more rapid so you can pump and deliver oxygen more quickly around the body. Your body will even liberate stored energy to make sure you have enough available to handle the situation.

Ideally, this whole ordeal is followed by a recovery period. That way, after handling the strain or threat you’ve been faced with, you can tell your body, “we’re good now, the threat is gone” and shift back to rest and digest mode. But this isn’t always the case.

What happens when we get too stressed?

Long-standing stress, meaning you’re dealing with stressors without getting a decent recovery phase, keeps these responses activated. It won’t always feel like a shot of adrenaline—instead of staying in an alarm phase, your body gets stuck in a resistance phase, continuing to fight and providing the responses it thinks you need. Your nervous system doesn’t get a break. This can make you feel fatigued, anxious, depressed and lead to issues falling or staying asleep. It can lead to weight gain or loss, issues with concentration, focus, memory. It can result in abnormal digestion (constipation or loose stools), or you might break out into rashes or hives. There are lots of consequences of experiencing non-stop stress.

This is common in people with highly demanding jobs, those who are caretakers, are faced with difficult or abusive people, have experienced trauma, have financial or legal burdens and those who have anxiety disorders. 

The issue is when you’re stuck in stress mode, your body tries hard to protect you—sometimes too hard. Your body thinks you’re dealing with a major threat and doesn’t think it’s safe to be pregnant, so it decreases the chance of pregnancy in an attempt to protect against the stress-related health risks to pregnant-you and a growing fetus.  

How does stress affect fertility?

Stress can affect the function of the ovaries and testes, starting in the control room. This control room (the hypothalamus) is where the signals to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) originate. This control room gets messages from the body’s hormones to tell it how operations are going (like feedback). So, for example, when you have too much estrogen in the body, it can tell the hypothalamus to slow down on sending the signals for FSH and LH. (This also happens in men with high testosterone—it tells the hypothalamus to turn the LH and FSH taps off and can interfere with sperm production). The same is true of stress hormones: high circulating cortisol is a feedback message to the control room and tells it to slow down the release of reproductive hormones. That’s why you may miss your period or have a longer cycle after experiencing a stressful event. Stress can inhibit the LH surge, leading to mis-timed ovulation, or no ovulation that cycle at all.  Chronically elevated cortisol can also directly affect the ovaries. High cortisol in the ovaries can affect egg maturation and their ability to be fertilized.

How are stress, sleep and fertility related?

Additionally, there’s a tight and very opposite relationship between cortisol and melatonin, your sleep hormone. Under normal healthy conditions, cortisol levels are lowest at night and highest around mid- to late-morning. Whereas melatonin is highest at night (sleepy time!) and lowest during the day when we’re exposed to daylight. Cortisol suppresses melatonin, so having chronically elevated cortisol can negatively affect your sleep, causing issues falling asleep, and waking you up in the middle of the night. These sleep disruptions negatively affect fertility since your body relies on a regular circadian rhythm to turn certain genes on and off.

Does stress affect male fertility?

High cortisol can slow down LH, interfering with testicular function and sperm development. Testicular Leydig cells, Sertoli cells and even premature sperm cells have cortisol receptors on them, so long-term or chronic stress may decrease their ability to function. In one study of 34 healthy medical student volunteers, sperm samples were taken just before their final examinations (stress period), and three months later during a non-stress period. Semen samples during stress had a higher amount of abnormally formed (poor morphology) sperm compared to semen during the non-stress period.

How do I manage stress to reduce its impact on fertility?

What happens if you can’t avoid the things or people that cause stress? The goal is to retrain the nervous system on how to react to non-alarm threats and override the control room. When the smoke appears you basically need to be able to tell your brain, “I know this looks bad, but it’s not a fire! You don’t need to call 911, I just need to open the windows and air the room out.” Which is a nice visual to keep in mind when we discuss using breathing techniques for stress below.

Your ability to cope and manage these reactions can change your body’s biological response. If your heart rate starts racing and your breathing becomes rapid and shallow, remember that you can override the control room. Take over and mindfully take a few slow, long breaths. This alone can help change your nervous system signalling. There are many tools you can use to help cope with stress and reduce your body’s stress responses. Not every tool will work for each individual so it’s important to try a few things and see what works best for you. Some examples include:

Guided meditation

Guided meditations are audio tracks that guide you through a relaxation method. You can find free ones on streaming sites, and there are plenty of great meditation apps as well. They can vary in length from a few minutes to an hour. There are also different types of guided meditations from environmental (imagine yourself in a peaceful place) to body scans (being aware of and relaxing all the muscle groups in your body).


You don’t have to be a writer to journal, nor does a journal need to feel like a diary. There are many forms of journaling for different personalities and time allotments, including one-line-a-day journaling, gratitude journaling or freewriting. You can write poems, song lyrics or even just a single sentence that summarizes your day or feelings.


Physical activity is a great way to burn off steam, process your feelings and clear your head. You can do an activity with a friend, a group or by yourself. Go for a jog, a bike ride, a swim or a walk. Join or organize a game like volleyball, badminton or tennis. Take a class like step-aerobics, dance, barre or yoga. Get outside or stay in. Put music on and dance around. There are plenty of ways to address your stress with movement—and many of them support fertility with exercise.


As mentioned above, controlling your breath can change your emotional and stress response. The main goal is to slow and deepen your breath, which overrides short, shallow breathing. Long exhales can slow a rapid heart rate and decrease anxiety. As you work through your breathing, recognize any tension in your body and let it go. Do not forcefully hold your breath—it should be smooth and slow. Try about four to six counts in, and six to eight counts out. If you become lightheaded or dizzy, stay seated and change your breathing pace.

Other self-care and stress reduction activities:

  • Listen to music
  • Cognitive Behavioural Therapy (CBT)
  • Drawing, colouring, painting, needle crafts
  • Work a puzzle
  • Read something you enjoy (could be self-help, inspirational, fiction or non-fiction)

Other tips to reduce stress:

Try to work in five to twenty minutes of self-care each day. Avoid watching the news before bed and stay off social media if it tends to give you anxiety or increase stress. If you need additional support, reach out to a mental health professional such as a psychotherapist or social worker who can help you process the stressors in your life and navigate stress management.