Can anxiety cause infertility?

Honestly, infertility definitely is directly proportional to anxiety.

Anxiety has been linked to infertility, and while anxiety can’t make someone permanently infertile, it appears that it can decrease the likelihood of pregnancy.

Anxiety and stress in these patients equal that of patients with cancer. Studies show that stress may negatively affect the conception rate and that stress reduction may improve it. The inability to conceive while all around seemingly everyone else does so successfully often leads to frustration, depression, and anger. Such stress may strain the marriage, wreak havoc in a sexual relationship, and adversely affect work performance. Patients with infertility often overlook the fact that the natural conception rate per cycle in humans is at best 20-25 percent.

Women feel their time slipping away. The baby clock is ticking loudly. They are acutely aware that each menstrual cycle that comes means they are not pregnant. Many feel like a failure, and it brings them closer to not having any eggs left and being irrevocably infertile.

Each period is not only a reminder that they are not pregnant but also a reminder that they are getting older and closer to menopause. My patients typically obsess over every detail of their cycle. Generally under acupuncture and herbal treatment you do see an improvement in a woman’s menstrual cycle. Their cycles become more regular, less clotty dark blood, there is less PMS and cramps/pain. But the human body is not a machine and while steady improvement can be seen at times, it does not always happen that way. Some cycles are worse or there is no improvement.

Most of the time, the first cycle a woman has after starting acupuncture is dark, heavier, clothier and sometimes more painful. Besides this, my patients’ lives are not regular, they go on vacation, eat and drink too much over holidays, go on business trips, have stressful things happen in their work and family lives. All of these things have an impact on your menstrual cycle. They also have an impact on your sleep. However having a bad night’s sleep because you drank or ate too much makes it much easier to see the causal relationship from act to consequence, and you only have to wait until that next night to see change or improvement. To see change or improvement in a menstrual cycle you have to wait a whole month. The link between cause and effect (lifestyle/diet changes) is too long to easily make a direct link in your patient’s mind. Again that is 30ish days to worry about and overanalyze every little detail, which leads to increasing anxiety.

What exactly is anxiety? According to the Free Dictionary’s medical section: “Anxiety is a multisystem response to a perceived threat or danger.” In other words, the root of anxiety is fear, a fear that you will not be able to protect yourself. In the case of my patients, their fear is multi-faceted.

“With this relatively newfound freedom, woman has flocked to the workforce. They have dedicated themselves to building their careers. They are fulfilling their own considerable personal and individual potential. But like every choice in life, there are always consequences.”

One big fear is that they have made a mistake and put off having a child and now it’s too late. The generation of women now in their late 30s early 40s were raised on the empowering messages of feminism and equality. They rightly believe that they can do anything they set their mind to. They can be CEOs, astronauts, screenwriters and carpenters. They hopefully believe, that if they want to do something, that if they work hard enough they can do it. It is the American dream.

With this relatively newfound freedom, woman has flocked to the workforce. They have dedicated themselves to building their careers. They are fulfilling their own considerable personal and individual potential. But like every choice in life, there are always consequences. The consequences these women are facing is that their reproductive systems don’t function as well as they did 10 years before, and their eggs are ageing along with them. This is another way of saying it is now harder for them to give birth to a healthy child.

Some of you might read into my words as a subtle message that I believe women should not be in the workforce and should be at home pregnant and in the kitchen. While it is true that I found my wife very sexy while she was pregnant, that is not the point. I feel for my patients. I see their struggles and I want to help them. I see some of them openly confronting the myth that you can have it all, whenever you want it. The consequences of that ideal is a slightly darker side of the American dream. We run smack into the cult of “me,” that just because you want it, you have a right to it.

How should stress be addressed?

Any stress-reduction strategy may be beneficial. Exercise, Yoga, massage therapy, acupuncture, acupressure, spiritual counselling, psychological counselling- all these might improve one’s outlook and reduce adverse psychological effects. Infertility support groups, where available, are also helpful. One has to be cautious, however, about shared information, either in person or via the Internet. In each couple, infertility factors are different and what applies to one may not apply to another. Taking a break from infertility treatment is often advised when stress becomes unbearable. This is particularly welcome in younger individuals for whom age is not yet a factor in the success rate. It is important for the physician to set limits and guidelines as to the extent and duration of treatment. A well-defined plan that outlines the type of treatment, the number of treatment cycles, and the alternatives, should be discussed with the patient early in the process and reiterated later. The patient should be assertive and ask questions, as well as express his or her anxiety to the physician or his staff. Bottling feelings inside may only lead to additional stress and frustration. The patient should be notified early that if he or she wishes to discuss alternatives or change the intensity of treatment, they should do so without hesitation. Infrequently, anti-anxiety or anti-depressant medications are prescribed.

stress may be work related and relationship related, but in many cases it’s actually related to the stress that men and women place on themselves to conceive, and the longer they try the more that stress can increase, thereby increasing the likelihood of further infertility.

There are so many different fertility tools these days that work extremely well, and seeing what the doctor says and what’s available is important.

But let’s assume that anxiety is causing your infertility. How can you reduce anxiety so that you’re more likely to conceive? The answer is fairly complicated and related to what’s going on in your life, but strongly consider the following:

Have Fun and Make Love – Your lovemaking plays a role in your anxiety. It’s great to keep to a calendar, but intimacy is also important for simply enjoying yourself, and making sure that you’re engaged with your partner and enjoying yourselves. Lovemaking shouldn’t be something you do as a chore because once you take that anxiety reduction tool away you’re left with one less way to stay relaxed and enjoy the moment.

Planning Fun/Distracting Activities – When anxious, the human mind becomes your enemy. While stress can make you feel like you want to be alone, the reality is that anxiety causes thought processes to err towards the more negative thought. So making sure that you’re keeping to a busy schedule and out having fun with friends and family is actually very important for anxiety reduction, relaxation, and ultimately conception.

Avoiding the Date – Often this is easier said than done, but you should also make sure that you’re not creating an arbitrary timetable to get pregnant. Pregnancy isn’t something you can rush, nor is it something you need to rush. Try to simply enjoy yourselves and see what happens while following your doctor’s advice.

Each therapy that is offered, therefore, should be repeated several times (usually 3-4) in order to give ample opportunity for successful conception. One should keep in mind, though, that repeated failures to conceive might generate more stress, which by itself may be harmful.

At the end, again the matter is vice versa.

Trying to soothe oneself, usually, end up with the fruitful pregnancy.

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Dr Madiha Munawar

The writer is a Lahore-based doctor. She can be reached at mukarramali3@gmail.com