Stress, hormones, and our fertility

Our cycles are an amazing barometer of our overall health. Everything from menstrual cramps to late-cycle spotting to really, really long gaps between periods is significant and says something about the overall state of our bodies. For example, stress shows up very clearly. On Friday I chatted with my friend Anna--who is gearing up to be a phenomenal Fertility Awareness Method instructor--about the specific ways that stress robs our body of sex hormones. Cholesterol is the precursor to estrogen, progesterone, and testosterone (which is one reason why a low cholesterol diet isn't all that healthy for you, but rather we should be seeking out a healthy cholesterol diet). Before sex hormones form, however, cholesterol becomes pregnenolone, then either becomes DHEA (and goes on to make estrogen and testosterone) or it becomes progesterone.

Just to give a quick snapshot of reproductive hormones, estrogen prepares the body to become pregnant during the first half of the cycle (the "follicular phase"), doing things like softening and opening the cervix, creating cervical fluid that helps sperm make their way to the egg waiting in one of the fallopian tubes, and plenty of other things as well. Progesterone is dominant during the second half of the cycle (the "luteal phase") and helps to maintain a pregnancy. So, estrogen prepares, progesterone maintains.

During a stress response, say, zombies, the body does two things. First, it activates an immediate "fight or flight" response sending blood away from our core and into our extremities, it increases heart rate, eyes dilate, and so on. Second, the stress response also initiates a longer chain of events, releasing the hormone cortisol which in turn tells the liver to up our blood sugar (glucose) to give us the energy we need to fight or flee.

Our body doesn't differentiate between stress caused by a zombie chasing us or by sitting in traffic for an hour when we're already late for a meeting, or hating a co-worker, or being a single mom of three with little support, (or taking anatomy, midwifery, and herbalism classes while having a full time job and being a wife...). When we're constantly stressed, the normal cascade of hormone production alters because we're telling our bodies that we need more cortisol to handle the stress. Instead of making DHEA (and then estrogen and testosterone), the pregnenolone is used to make cortisol. This process if called the "pregnenolone steal" because the body is "stealing" pregnenolone away from making sex hormones. Eventually this will lead to depleted cortisol on top of the depleted estrogen, progesterone, and testosterone.

This can show up in our fertility in different ways. You might see spotting during the week before getting your period. If you're charting, you'll see your temperatures going down during that week. For women who are trying to get pregnant, low progesterone can be a big problem--remember, it maintains a pregnancy. Addressing the hormonal balance issue is typically a multi-pronged approach that involves herbal support, diet changes, and lifestyle changes.

So, here's how I deal with stress (in a healthy way. My not-so healthy list isn't pretty, but at least it's shorter.):

  1. I'm a big advocate for things like yoga and other mind-body exercise routines.
  2. I like to work with "adaptogenic" herbs that help the body adjust to stress, herbs like ashwaganda and licorice.
  3. Setting boundaries and saying no.
  4. Giving myself permission to not have to clean everything, all the time.
  5. Me time.
  6. I cut out sugar and rarely drink caffeine. (I don't know how I managed to get rid of sugar, but I'm giving myself a freakin gold star for that. I still eat dates and other dried and fresh fruits, but, damn, no more processed sugar makes a huge difference).

Reishi mushroom we found here in Boston. Hard as a rock. I definitely recommend ordering them sliced (or using power tools).

Here's a nice little tea for the herbally-inclined that specifically addresses the relationship between stress and fertility, with some great immunity-boosting herbs to boot. It's one of my favorite winter tonics.

  • 1 qt filtered water
  • 2-3 slices of reishi mushroom
  • 4-5 slices of astragalus root
  • 1-2 tsp ashwaganda root
  • 1-2 tsp shatavari root
  • tsp licorice root
  • 6-8 pieces of sliced ginger

Boil for an hour until it reduces about three quarters of the water, drink 1-2 cups daily. A great source is Mountain Rose Herbs, based in Portland, Oregon.

Long thinking: Or, how making miso is like making babies.

Blood drawing: Just get over it...