Stress and Fertility Through a Functional Medicine Lens

Story by Rebecca Roberts / January 28, 2022

By Dr. Cici Carter

 When we’re under long term stress, our glucocorticoid hormones increase. When this happens, certain pathways get turned off in order to direct the needed energy that allows us to fight or flee. We’re going to talk about the reproductive pathway. When we’re stressed, this pathway is not seen as essential. We could be feeling generally well as we’re trying to conceive, but we’re likely getting bombarded with stress. There’s your SO, other family members, other kids to take care of, a job to do, a house to clean, the list goes on. So, what do we do about it? Well, sometimes, we need to take a break. This is a physiologically complex process with many parts that have to align at the right moment in order to conceive. Understanding this fact is something we all have to respect. 

Our Stress Physiology

The physiology of the stress pathway in regards to reproduction is like this. First, we have a stressor. Next, our cortisol levels respond by increasing causing a shift away from making progesterone, testosterone, and our estrogens so we can continue to survive said stressor. That is the main purpose of cortisol; to help us survive. By having these elevated levels of cortisol coursing through our bodies, we lose the needed materials to make our sex hormones. This is what’s known as “Cortisol Steal.” Now we no longer have the right balance of our sex hormones for reproduction. 

Our Thyroid Physiology in relation to Stress

 This elevated cortisol level also negatively impacts our thyroid function. Cortisol prevents the active form of T3 from being produced in adequate amounts contributing to hypothyroidism. Thyroid health is essential in maintaining hormonal balance with estrogen and progesterone. It impacts ovulation and the health of the egg itself, and if abnormal during pregnancy, can lead to miscarriage or premature birth. The hormonal imbalance typically involves low levels of progesterone, making it harder to maintain the uterine lining which is essential for implantation and growth of the fertilized egg.

 Stress and Male Reproduction

Testosterone production is essential for the health and development of sperm; a necessary component for baby making (duh). Stress, along with inflammation and hyperinsulinemia, inhibit an enzyme called 17,20 lyase; the enzyme responsible for converting 17-OH-pregnenolone and 17-OH-progesterone to DHEA and androstenedione to testosterone. (Basically it blocks a major step that is essential.) Less testosterone means more dysfunctional sperm – deformity, poor motility, low volume; detracting from the goal of successful pregnancy. 

What Can We do about it?

Elevated cortisol impacts our health in more ways than this, but this is meant to highlight and briefly describe the relationship cortisol has with our reproductive system. You can start positively impacting your cortisol levels by initiating stress reduction techniques at home. This includes meditation, practicing mindfulness, or being out in nature as just a few simple ways to help create more balance concerning your cortisol levels. Getting adequate sleep and moderate exercise also helps. If you’re struggling to create more balance in your life, consider a health coach to assist you, and if more intervention is needed, FreshMed is here to guide your physiology back to normal!  



(843) 714-0709

1700 Ashley River Rd.
Suite B
Charleston, SC 29407