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Infertility is one of the most stressful situations for my Ob/Gyn patients. The inability to become pregnant can take a toll on a woman’s relationships, mental health, and physical health. In fact, research suggests that infertility can cause as much stress as being diagnosed with cancer.
The body can respond to stress by releasing hormones, which can cause symptoms that mimic several health conditions, such as depression and insomnia. Stress can also make existing mental health symptoms worse—with longer-lasting consequences than you might think.
A new study published in the journal Menopause has found that struggling with infertility can also increase the risk of having mental health symptoms of menopause later in life.
The study enrolled almost 700 women and followed them for an average of 18 years. Data showed that women with a history of infertility were found to have a higher risk of sleep problems, depressive mood, and irritability during midlife after ruling out other potential causes for these symptoms.
One in eight U.S. couples has difficulty achieving or maintaining pregnancy, and about 7.4 million women of reproductive age have received treatment for infertility. That means a lot of women are at risk for potentially severe menopause symptoms. If you’re experiencing infertility or symptoms of menopause, there are treatments that can help.
The relationship between stress and menopause.
A patient’s reproductive history is one of many factors that can influence when menopause begins and how symptoms are experienced.
About one third of the study’s 695 participants reported having experienced infertility, higher than the national average of about 19%.
When they were asked to report their symptoms, participants who had experienced infertility were more likely than others in the study to score highly on the Menopause Rating Scale for depressive mood, irritability, and sleep problems during midlife. Other menopause symptoms and age of menopause were not found to be related to infertility.
This shows that the stressful experience of infertility can have effects on mood long after a woman’s childbearing years have passed.
Stressful life events are associated with reports of more menopause symptoms. I have seen patients who immediately began experiencing symptoms of menopause after a particularly stressful event.
Overall, about 85% of women report varying degrees of menopause symptoms, such as:
- Hot flashes
- Vaginal changes and infections
- Irregular periods or bleeding
- Difficulty sleeping
- Memory problems
- Urinary challenges
- Mood changes
- Depression and anxiety
Decreasing estrogen and testosterone levels in menopause can cause mood, cognitive, and sleep symptoms. However, long-term stress associated with infertility can cause hormonal fluctuations that result in symptoms so similar it can be difficult to tell the difference.
The good news is, there are effective treatments for symptoms of stress and menopause that can help you feel better and get better sleep. And for patients currently struggling with infertility, there are many options to increase your chances of becoming pregnant.
Treatment for infertility in women.
It takes two to conceive. About a third of the time, we don’t always know why conception is difficult for some people. About a third of the time it is because of challenges for the male partner, and about a third of the time it is the result of the woman’s body. For women or couples who have difficulty conceiving, there are treatments available.
There are several medications that can help. Some, like clomiphene citrate, letrozole, and others work by causing the ovaries to produce eggs. Others, like metformin, are designed for women with insulin resistance or diabetes.
Intrauterine insemination, often called artificial insemination, is a procedure in which prepared sperm cells are placed directly into a woman’s uterus. This method is sometimes combined with medications to encourage ovulation.
Sometimes, eggs or embryos are handled outside the body. These fertility treatments are called Assistive Reproductive Technology. Eggs are removed from the patient’s ovaries and combined with sperm in the laboratory. Fertilized eggs are then returned to the woman’s body or donated to another woman who will carry the baby (called surrogacy).
If you are experiencing symptoms of depression, there are ways we can help.
Treatment for mood challenges during menopause.
At Medstar Health Women’s Health, we screen every patient for depression and anxiety no matter their age and no matter the reason for their visit. If you have menopause-related symptoms, be sure to talk with your doctor. We’ll talk with you about your reproductive history, including any fertility challenges, in a respectful conversation that helps us understand your risk.
It is important to talk with your doctor if you are experiencing feelings like hopelessness, worthlessness, or emotional numbness. If you are crying a lot and losing interest in your normal activities, we can help you navigate these depression symptoms.
If you have depression related to menopause, hormonal medications like an estrogen patch may be able to help. Other treatments include medicines such as antidepressants and methods like psychotherapy. The most important thing is getting help for your symptoms, and that’s why we’re here.
A lifelong partnership for patient health.
My colleagues and I build lifelong relationships with our patients, many of whom we care for from puberty through their childbearing years and into menopause. This allows us to more fully understand how their lives influence their health.
Infertility can be uncomfortable to discuss. Treating infertility and its surrounding symptoms can help many couples start a family. The experience of infertility can have long-lasting effects. This research helps us better understand the toll it can take so we can be better prepared to support our patients.
Be sure to talk with your doctor about your reproductive history, especially if you have symptoms of menopause. With this research in hand, we’re even better able to help you understand how your health past influences your present and future, and to help you find effective treatments.