Nonstop pressure and chronic stress may have a significant affect on fertility and may prevent some women from getting pregnant, according to experts.
"I like to say a little of this and a little of that is worse than you think for your reproductive system," said Dr. Sarah Berga, of Emory University School of Medicine.
Berga, who has studied the impact of stress on fertility for years, said while humans are designed to deal with a certain amount of stress, chronic stress may prevent some women from ovulating.
She said it starts with the hypothalamus, the part of the brain that controls the release of hormones.
"Your brain is hard to fool. If you're undereating, overworking and overexercising, the hypothalamus is, in essence, keeping a running tally of what you're doing," Berga said. "Even though you can say to yourself, 'I'm not stressed.' Your hypothalamus may come up with a different answer."
If the hypothalamus senses stress, the messages sent to the ovary to release eggs may be interrupted and cause stress-induced infertility. It's an interesting process, but one that patients and even some doctors may find difficult to accept.
Susan Epstein, 49, spent years running herself ragged, not only as a long-distance runner, but later as a busy wife, student and exercise physiologist.
Oral fertility drugs helped her get pregnant with her first child, but when she attempted to get pregnant a second time, Epstein couldn't. Even three rounds of IVF didn't help her.
After visiting Berga, Epstein, who defines herself as "a get up and get going kind of woman," found out stress was inhibiting her fertility.
"I was into my career and my husband had a professional career. I had a small baby. I was new at all those things," Epstein said. "I was also exercising, still running every day — trying to keep everything afloat."
But, she said she had a difficult time believing her lifestyle could be hindering her from having the child she desired.
"I had a really hard time thinking it was me because you want to get an answer, so they can fix something — you know a prescription, a pill," Epstein said.
Berga said it is often difficult for women to learn less stress can increase their fertility.
"Suddenly, we're telling them, 'you need to alter your lifestyle in some way. Run less. Eat more.' This can sound like pretty bad news," Berga said.
But, for many, stress-related infertility can be reversed. In one study, Berga found ovulation was restored in seven out of eight women who underwent talk therapy, compared with two of eight who did not.
After hearing her lifestyle might be affecting her fertility, Epstein decided to de-stress her life. She left her job to take care of her baby, and made a conscious effort to relax. She took up yoga and piano.
"I had to stop running. I had to gain some weight. I had to take more time for myself," she said. "It sounds like exercise was time for myself, but that was really part of my whole stressful routine."
To her surprise within four months and without any medication, Epstein was pregnant. Her daughters are now 11 and 7.
"It was such a relief to like let go, for me," Epstein said. "I think it must have sent all the positive hormones in my brain that said, 'OK, you're ready now.'"