Cortisol — also known as “The Stress Hormone” — is important to be aware of, even if you’re not dealing with fertility issues. It mediates the stress response, regulates metabolism and inflammatory processes, and stabilizes immune function. Too much or too little cortisol can impact the body, and when it comes to fertility, can negatively affect ovulation and menstruation

Some of the things that contribute to imbalanced cortisol levels are depression, anxiety, and stress-inducing factors, making it no surprise that fertility challenges could cause a spike. So, how does cortisol work in the body? How and why do things go awry? How can we learn about our cortisol levels in relation to our fertility, and what can we do about it?   

How Cortisol Works In the Body 

Put simply, cortisol is a steroid hormone produced in the adrenal glands. It’s synthesized from cholesterol and released from the anterior pituitary gland, which is the butterfly-shaped gland at the base of the throat. It increases the glucose (sugar) in the bloodstream and helps the brain use that glucose more efficiently. Cortisol also helps get tissue repair started if it’s needed. And since glucocorticoid receptors (receptors that can receive the hormone) are in almost all body tissues, cortisol can affect practically every organ system.

When we are in stressful, life-or-death situations, cortisol gives us that push we need to survive. To put things into slight hyperbole, think of mothers lifting cars off children, running for their life, or fighting off an attacker. It’s supposed to act as the “Let’s DO This” hormone, providing quick bursts for the body to get through times of incredible stress. During those times, every bodily system or function that isn't necessary for survival shuts down, including those surrounding reproduction. 

Stress and Cortisol

Problems with cortisol — especially when it’s too high — begin when we experience levels of stress that don’t let up. That doesn’t mean one bad meeting or two or three bad days; it means sustained pressure affecting the mind, emotions, and, inevitably, body. 

When we’re under stress, we know our cortisol response is triggered — the little bursts meant to get us through these moments. But when we are under constant, or near-constant, stress, the cortisol response never stops being triggered, affecting immunity, digestion, and even fertility. The more stimulated and stressed you become, the more likely you are to push your cortisol levels too high — and, in a rebounding effect — they will crash, causing more issues.

How High Cortisol Affects Fertility

The hypothalamic-pituitary-adrenal axis (HPA) of the brain is where cortisol is produced and is an essential factor in fertility. The HPA is involved in the work of the hypothalamic-pituitary-gonadotropic axis (HPG), which is responsible for regulating reproductive activity and the release of ovarian hormones. Chronic stress and, in turn, high cortisol levels, can cause a disruption in the HPA and HPG axes, which may then lead to imbalances in hormone levels. 

More specifically, elevated cortisol levels can have a “dampening effect” on the gonadotropin-releasing hormone (GnRH), which then causes the body to not signal the pituitary gland to release FSH and LH. The connection between your brain and your ovaries is disrupted and may cause ovulation to be delayed or absent —  and your period to be irregular or missed. High cortisol can also reduce the production of estradiol and deteriorate egg quality.

Experts theorize this is how the body protects you from yet another stressful experience — pregnancy. Stress is also likely to decrease your libido, leading to less frequent opportunities for sex when trying to conceive. 

How You Can Tell If Your Cortisol Is Imbalanced

Going through infertility causes mental, emotional, and physical stress. Unsurprisingly, several studies have shown women in Assisted Reproductive Technology (ART) have abnormal cortisol levels. And, of course, the longer you are going through ART or experiencing elevated levels of stress, the more imbalanced your levels are likely to be. Of course, our separate methods for coping and thresholds for stress are different, depending on many factors, like genetics, circumstances, and even childhood events or traumas.

One way to tell if your cortisol or other hormones are imbalanced is to look at your menstrual cycle: Are you experiencing missed or irregular periods? Worse-than-usual PMS? If you’re not ovulating, it could be causing disruptions in your mood.

Another way is to objectively observe your general state of being: Do you feel stressed out more than not? Are you having trouble sleeping? Is your digestion off? Are you getting sick more often than normal? Do you feel generally depressed? Burnt out? You might have an imbalance.

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What You Can Do About It

There are several ways to test your cortisol levels. While you wait for results, you can take steps to rebalance your cortisol — or keep it in balance if there is no concern.

Share your experience with a supportive friend or family member, and work on stress management and coping strategies. There are many qualified therapists, counselors, faith workers, and more that you can use as a resource. Meditation, journaling, getting quality sleep, and acupuncture are also great tools to work through stress. 

When it comes to exercise, regular, moderate exercise can improve overall health and fertility, but excessive exercise can be counterproductive. Pushing your body to exhaustion can increase cortisol and stress hormones and decrease gonadotropin hormones, leading to ovulation dysfunction and irregular periods. So while it's important to keep moving, try not to overdo it. 

As always, speak with your medical provider before many any drastic changes to your diet, exercise, or supplement routine. And remember to nourish yourself during this time. 

Kristin Diversi is a writer and versatile creative. She is passionate about reproductive health and justice and lives in Longmont, Colorado, with her husband and their son.