Does mental illness or anxiety affect women’s fertility?
Infertility as a cause for depression and anxiety is familiar; however, infertility because of mental illness including depression and anxiety has been an obscure topic of discussion. While infertility can, undeniably have a huge impact on the psychological well-being of an individual, the connection between the two is intertwined, and works vice-versa.
Studies have shown that psychological illness can play a role in the ability to conceive and the ability to carry a healthy pregnancy. Stress impacts hormone levels, having an inverse relationship with estradiol (major female sex hormone) concentrations. Hence, unrelieved perceived stress may have a negative affect on overall estradiol production, thereby hindering ovulation and suppressing reproduction.
Mental illness like stress, depression, and anxiety have all been associated with inflammation. Chronic inflammation do have a possibility to interfere with attempts to conceive and hence, affect fertility. In a research about women undergoing infertility treatment, higher anxiety levels were linked to various inflammation markers. Common mental disorders are also associated with poorer physical health due to a range of factors including increase in inflammatory responses and higher possibility of indulgence in smoking, alcohol, eating disorder, and low physical activity. The aforementioned factors result in inferior reproductive health, affecting fertility severely.
While untreated mental illness can aggravate the factors consequential to the same, the use of antidepressants can also affect fertility. A study examining the influence of antidepressant use on natural fertility learned that women on medication were less likely to conceive, than women who were not on medication.
Antidepressants work by balancing chemicals in our brain; and since women’s menstruation is controlled by the interaction between ovaries, uterus and the brain, any illness or medication that deters this communication could have a huge impact on ovulation and hence, make it difficult for women to achieve pregnancy. A study supported this research by observing that women taking antidepressants in the form on SSRIs (selective serotonin reuptake inhibitors) took significantly longer to get pregnant. They were also observed to reduce the success of infertility treatments. Furthermore, women going through depression are likely to experience menopause at an earlier age than women who do not suffer from the same.
Depression and anxiety has a detrimental impact on fertility. Women with severe depression and anxiety need continuous and extensive support to balance their mental and physical health to lessen the risks of infertility and pregnancy health due to mental illness. Women with psychological problems like such have poorer physical health and are more likely than other women to be vitamin D deficient and less likely to take comprehensive care of themselves before and during pregnancy.
There is abundance evidence that both, maternal mental illness like depression and anxiety as well as its treatment, in the form of antidepressants, can affect fertility and pregnancy outcomes. However, such a situation is not untreatable. In case of pregnancies, a risk-free situation does not exist and a decision has to be made with respect to starting or maintaining medicinal treatment of mental illness considering pregnancy. Acceptance of the situation, being transparent with the respective doctor and deciding to take an active step towards addressing this problem is advised and expected to open a lot of options with regard to the same.
About the author -
Senior IVF consultant and Clinical Director, Ferticity Fertility Clinics
