How Burnout Affects Fertility

Sep 1, 2021

Dr. Ashley Margeson, ND

Dr. Ashley Margeson, ND


Thinking about having a baby is stressful enough. But did you know what many women also believe that being stressed contributes to their fertility concerns? This is a real conversation that I have so often in my office, and I want you to stop being so hard on yourself! 

No, this isn’t a punishment for working too hard. No, you didn’t wear your body out. No, that abortion you had didn’t cause your fertility concerns 1, 5, 10, 15 years later. No, it’s not your fault that you can’t “relax”. These are misgivings that social media and culture teaches us that has nothing to do with your body’s ability to make or create or sustain a pregnancy.

Here is how burnout and stress can affect fertility. And conversations you can have about it.

Want to know what the research supports? 

That infertility certainly causes stress, but not always vice versa.

In fact, even when physical stress or emotional stress does interfere with your menstrual cycle, stress-induced hormonal changes are usually self-correcting and self-limiting. That means when there is a fertility problem that follows stress, the stress was most likely a trigger for a pre-existing medical condition or predisposition. Want to know what else this means? 

That we can do something about it.

Speaking of those hormonal changes? How exactly does burnout affect our fertility? 

It Lowers Progesterone

Our hormones aren’t created and metabolized in isolation; rather, they act as a cascade! Progesterone is a precursor hormone to cortisol. This means that when stress increases, more progesterone is shuttled to make cortisol and progesterone subsequently decreases. Adequate progesterone is necessary for the support of the developing embryo, implantation, and preventing a miscarriage.

It Lowers GNRH

The hypothalamus is found in the brain and acts as the chief endocrine gland. It controls the release of all hormones and is sensitive to regulatory feedback. Gonadotropin Releasing Hormone (GNRH) is released by the hypothalamus to signal the pituitary to release FSH and LH. FSH is important for egg maturation and LH is important for ovulation.  Thus, without appropriate GNRH signaling, egg development and release can be impaired or even halted. This is an extremely important factor to consider in hypothalamic amenorrhea.

It Negatively Impacts Thyroid Function

The hypothalamus also controls thyroid hormone production by releasing Thyrotropin Releasing Hormone (TRH), which then signals the pituitary to release Thyroid Stimulating Hormone (TSH) to stimulate your thyroid to release thyroid hormone. In periods of chronic stress, this too is shut down! Furthermore, both physical and emotional stress will increase the production of reverse T3 (rT3), an inactive thyroid hormone. Now only does the production of rT3 take away from your production of T3 but also docks on the T3 receptor site, blocking your active T3 hormone from binding.

It Increases SHBG

Elevations in cortisol during stress trigger the liver to release more sex hormone binding globulin (SHBG). SHBG is a protein that will bind testosterone. When testosterone is bound, it is not free to act on cells. Moreover, total testosterone has little relevance; rather, free testosterone is what matters! When it comes to fertility, testosterone is essential for egg quality AND sperm health. Furthermore, adequate testosterone is necessary for a healthy libido, an important factor when trying to conceive.

If you’re concerned that your burnout might be affecting your fertility, or you want to get a head start on optimizing your body for baby – touch base using the contact form below.


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