Infertility caused by stress helped by behaviour therapy

Jun 21 2006

According to an American scientist infertility caused by stress can be helped by the use of behavioural therapy.

Professor Sarah L. Berga, from the Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, says contrary to commonly held belief, lots of small stress factors such as occur in everyday life, can play a major role in ovulation and often a collection of small stresses is worse for fertility than one big stress.

She says until now it was thought that amenorrhea, a failure to ovulate, was usually caused by such things as excessive exercise or undernutrition.

But often dieting and exercise she says, are a way of coping with psychosocial stress, and previous research has shown that such stress is often increased in women who do not ovulate.

Professor Berga and her team looked at the causes of functional hypothalamic amenorrhea (FHA) in women of normal weight who had not had a menstrual period for more than six months.

They confirmed the women were stressed by measuring levels of the hormone cortisol in the cerebrospinal fluid which increases with stress.

They studied 16 women with FHA who were divided into two groups; one group received cognitive behaviour therapy (CBT) for 20 weeks while the other group were observed.

Professor Berga says a surprising 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those who were just observed.

Berga says the study shows that there is an alternative to expensive hormonal medication in this instance and reducing stress through psychological measures can restore ovulation and fertility.

Berga says stress is a cause of infertility in men and in women, and it can be managed without drugs and by managing it you improve fertility.

It seems an estimated five to 10 percent of women suffer from amenorrhea, about half of which is thought to be related to stress.

Apparently two of the women who received CBT became pregnant shortly after finishing the treatment.

Professor Berga says the study underlines the important contribution that lifestyle factors play in determining overall health and reproductive health in particular.

The team now intend to follow up the work with a multi-centre trial involving a large number of women.

Professor Berga says if a larger study confirms the results they will have strong evidence for offering stress reduction as an effective therapy for a significant group of infertile women.