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COVID-19 Stress and the Reproductive System!

There is no question that the COVID-19 pandemic has impacted people physically, mentally, professionally, and economically, all of which circles back into the system as perceived stress.

Stress can do much damage to any body system or organ. The woman’s reproductive organs are at particular risk such as ovulatory disturbances, menstrual irregularities, the flare-up of existing disease such as endometriosis, increased weight gain, which can aggravate polycystic ovarian syndrome, vaginal disturbances from immune suppression, and fertility. And, this can all happen without even contracting the COVID-19 infection. Possibly the only benefit of COVID to the reproductive organs is a lower risk of sexually transmitted infections (STI) due to social distancing, less outside interactions, and more caution in exchanging bodily fluids. Besides worrying about catching an STI, now people must worry about COVID transmission, and no condoms can mitigate that risk. Masks are to COVID what condoms are to STIs.

Stress and the Hypothalamus-Pituitary-Ovarian Interactions?

Both physical and emotional stress triggers the adrenal glands to release cortisol and epinephrine, the ‘fight-or-flight’ hormones. There exists a reciprocal relationship between the hypothalamic-pituitary-adrenal (HPA) and the hypothalamic-pituitary-gonadal (ovarian) (HPG) axes wherein the activation of one affects the function of the other and vice versa. For instance, both testosterone and estrogen affect the response of the HPA axis, while chronic stress has an inhibitory effect upon estrogen and testosterone secretion. As estrogen levels fluctuate, the reaction of the pituitary is unpredictable. This disruption affects ovulation, which then impacts fertility and the menstrual cycle. Any time there is a lack of ovulation, the menstrual cycle can come early or late, be light or heavy. Generally, this mismatch of estrogen and progesterone leads to irregular cycles that can persist for weeks. Chronic release of estrogen by the ovaries can trigger ovarian cyst formation and this is mediated by the epinephrine released by the adrenals in response to stress.

In another study, maternal stress altered proteins related to vaginal immunity and the abundance of Lactobacillus, the prominent bacteria of the pregnant and nonpregnant vagina. Loss of maternal vaginal Lactobacillus from stress resulted in decreased transmission of this bacterium to offspring. This further altered the microbiome of the baby’s gut which may correspond to disruptions in the brain-gut interactions that may adversely affect the developing brain, thus contributing to neurodevelopmental disorders. This finding supports the notion that stress, even when not pregnant, may adversely affect the vaginal microbiome in favor of bacterial that could lead to bacterial vaginosis or elevate the pH to trigger yeast vaginitis.

The point of all of this is that psychological stress can have a significant impact on the entire body, so measures must be undertaken to lower stress levels. This can be done with regular exercise like long walks, talk-therapy—as in calling your friends and family more, meditation, yoga, taking antioxidants like omega-three fish oil, and other herbal blends. Chamomile and lavender are known to be relaxing agents. Even CBD or cannabidiol has known relaxing and anti-anxiolytic effects. There are different formulations that can be eaten, vaped, or tinctures for under the tongue. CBD is made from the hemp plant, is safe if extracted properly, and legal if there is less than 0.03% THC such as that found in broad-spectrum CBD, CBD extracts, and most full-spectrum formulas.

  • Toufexis, D., Rivarola, M. A., Lara, H., &Viau, V. (2014). Stress and the reproductive axis. Journal of neuroendocrinology, 26(9), 573–586.

  • Jašarević E, Howerton CL, Howard CD, Bale TL. Alterations in the Vaginal Microbiome by Maternal Stress Are Associated With Metabolic Reprogramming of the Offspring Gut and Brain. Endocrinology. 2015 Sep;156(9):3265-76. doi: 10.1210/en.2015-1177. Epub 2015 Jun 16. PMID: 26079804; PMCID: PMC4541625.


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