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Healthy Pregnancy

The Stress-Infertility Connection

By Dr. Len Lopez
Nutrition and fitness expert The rate of infertility, miscarriages, and C-sections are at an all-time high. Add everyday worry and anxiety to the equation and you will easily see how stress can contribute to these problems.

Stress, as it does in so many areas of our lives, interferes with the reproductive process and is a major cause for infertility and miscarriages. The reason is simple: lack of progesterone.

The word progesterone means “for gestation,” which means that women, you need this hormone in its right balance if you want be become pregnant and stay pregnant. Progesterone nourishes the uterine lining in preparation of the implanted fertilized egg. It is progesterone that continually feeds and nourishes the uterus during pregnancy. Unfortunately, constant stress causes a decrease in your progesterone levels.

When you are constantly in that “fight or flight” mode because of stress, your adrenal glands will produce additional cortisol and adrenaline. This is a normal bio-chemical process. The problem is that in order to make cortisol, your adrenal glands need progesterone. This causes your progesterone to be used in making your stress hormones, as opposed to what it is designed to do —support your pregnancy. 

The adrenal glands cannot make cortisol without progesterone. Often referred to as the ‘progesterone steal,’ your body will steal however much progesterone it needs to make cortisol.

This is one of the primary reasons some women are having a hard time with infertility and miscarriages; they don’t have enough progesterone available to conceive or maintain a pregnancy. 

The body is designed for survival, and when you are constantly in that “fight or flight” mode, it is more important for the body to run away from the saber-tooth tiger than it is to have a baby. The constant demand for cortisol is going to reduce your levels of progesterone. Inadequate levels of progesterone not only interfere with the reproductive process, but that lack of progesterone is another reason so many women struggle with PMS, hot flashes, and night sweats— progesterone is being stolen away to make cortisol. The progesterone steal causes a deficiency, and also affects the balance of progesterone to estrogen and testosterone.

Supplementing with progesterone (I prefer sublingual progesterone over topical creams) can do wonders for so many women who are struggling with infertility, miscarriages, PMS, hot flashes, night sweats, and other hormonal imbalances.

However, I always encourage my patients to identify where the stress is coming from and support those exhausted adrenal glands. If we merely add progesterone without nourishing those adrenal glands, we are going to always have to supplement with progesterone. But if we strengthen our adrenal glands and manage our stress, we allow the adrenal glands to function the way they are designed to. Most importantly, you can never get your progesterone levels back to normal without first supporting and nourishing those exhausted adrenal glands.

Measuring those Hormones

Often women will tell me they had their hormones tested and were told everything was normal. Unfortunately, a one- time blood or saliva sample doesn’t give an accurate measurement of those hormones. That’s because they fluctuate so much in a month. A more accurate picture and diagnosis can be made when several hormone samples in a month can be mapped out to determine if there are any abnormal hormonal variations.

I encourage anyone who is struggling with infertility, PMS, or other hormonal issues to take anywhere from 7-11 saliva samples to get a clear and accurate picture of your monthly cycle. When you map out your monthly cycle, you can easily see if your hormones are truly staying within their normal range.

If you are struggling with infertility, it is very important to also measure your LH and FSH, in addition to estrogen and progesterone. Estrogen and progesterone tell us if your ovaries are getting the job done, while the LH and FSH are more indicative of the communication between your brain (pituitary) telling your ovaries to start the ovulation process. 

The Stress Connection

Low levels of progesterone are often attributed to your adrenal glands stealing your progesterone. This is why it is recommended to first measure adrenal function and see how much stress you are truly placing on your body. The best way to measure your adrenal function is with a saliva test that measures both cortisol and DHEA.

Cortisol and DHEA are direct indicators of how much stress you are placing on the body. The constant demand for cortisol will eventually exhaust the adrenal glands and disrupt the production of your progesterone, estrogen, testosterone, and DHEA. It is basic cause and effect,and you will never get your reproductive hormones back to normal if your adrenal glands are burnt out.

A good ‘adrenal stress panel’ will include four cortisol measurements and  two DHEA measurements, as well as a measurement for your insulin levels. Measuring insulin is helpful and indicative to adrenal function, because high levels of cortisol trigger increased insulin, which is associated with obesity, cravings, diabetes, high blood pressure, and heart disease.

The healing process is more than swallowing a handful of supplements. It begins by restoring normal function to the body. If stress is throwing your body out of balance, check to see if your adrenals need support. If they do, support them. Then it will be easier to rebalance those reproductive hormones.

Dr. Len LopezDr. Len Lopez is a nutrition and fitness expert and creator of The Work Horse Trainer.  He speaks extensively on diet, exercise, and how stress can affect your overall health and wellness.

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