Cortisol and Fertility

adrenal fertility infertility support ttc

Cortisol wakes us up in the morning, keeps us awake throughout the day, and keeps our metabolism firing.  It regulates blood sugar, which makes it one of the most important hormones in the body for keeping us alive.  It does all this, and it also gets released in response to stress.  If you’ve been trying to conceive for any length of time, you’ve probably already heard, just relax and it’ll happen.  Maddening, right?  But it’s been well-researched that stress, and cortisol specifically, do have an impact on fertility.  Here’s what the research shows us.  Cortisol is released by the zona fasciculata layer of the adrenal cortex and is regulated by the hypothalamus-pituitary-adrenal axis. Dysregulation in cortisol production can lead to a number of uncommon medical conditions, including Cushing syndrome, which is caused by excess cortisol, and Addison disease, which is caused by insufficient production. receptors are present in almost all tissues in the body. Therefore, cortisol is able to affect nearly every organ system: Nervous, Immune, Cardiovascular, Respiratory, Reproductive, Musculoskeletal, and Integumentary. 

High levels of cortisol can interfere with the normal functioning of the hypothalamus and pituitary gland, which are responsible for regulating the reproductive system. Specifically, cortisol can disrupt the balance of other hormones, such as estrogen, progesterone, and luteinizing hormone (LH), which are essential for ovulation and maintaining a healthy pregnancy.


In women, high levels of cortisol can lead to irregular menstrual cycles, decreased libido, and even infertility. Psychological stress has been identified as an environmental factor that can adversely impact fertility. Evidence suggests that infertility is a chronic source of stress that may lead to a range of health problems. Several studies have underlined a possible relationship between high levels of perceived stress and higher levels of cortisol, and infertility. PMID: 29026481


Furthermore, chronic stress, which can lead to high cortisol levels, can also have an impact on fertility. Studies have shown that women who experience chronic stress may have a harder time getting pregnant and are more likely to experience complications during pregnancy.  But don’t stress yet: keep reading for what you can do to support your stress responses!


In men, cortisol can interfere with testosterone production, leading to low sperm count and decreased fertility. A study found that emotional stress can have a negative impact on the quality of semen. This is likely due to increased cortisol levels inhibiting the conversion of androstenedione into testosterone, resulting in reduced testosterone production and decreased sperm count and concentration. PMID: 16136011


As a species, our response to stress has not changed in hundreds of years, producing cortisol as part of the ‘flight or fight’ response to danger.  The stressors we faced 200,000 years ago are very different from the ones we face today (think an angry lion vs. a deadline) but our bodies don’t necessarily know the difference. Sex hormones including estrogen, progesterone (in females), and testosterone (in males) along with cortisol, are all derived from cholesterol. When we experience stress, our bodies shift the emphasis of hormone production away from testosterone and progesterone and towards cortisol.  Not ideal for conception.  But there are ways to address this!

Here’s the good news!  You can take action today to help change your body’s perception of stress.  


    1. Diet and lifestyle shift. A healthy diet can reduce stress on the adrenal glands, which in turn can help keep your cortisol and reproductive hormones in check. This can be beneficial for both men and women looking to improve their fertility. When your blood sugar gets too low, cortisol jumps in to raise it (and keep you alive).  But then if blood sugar goes too high, our body can overreact and then it swings too low, and then you want a cookie and a coffee, and you end up with high highs and low lows. With a lot of cortisol activity! That's why it's important that your blood sugar level rises and falls at a steady pace. Avoid meals that are high in sugar and refined carbohydrates (pastas, breads, white rice). Instead, opt for meals that contain healthy fats, fiber, and protein. These will give you a slow, steady rise in blood glucose levels, rather than a quick spike! 
    2. Make sleep a priority. Getting 8 hours of sleep with the first 1-2 hours occurring before midnight is a great way to work with your natural cortisol rhythm. . Going to bed earlier, around 10 pm, helps your body reach its normal hormonal rhythm, which helps to reduce stress. Plus, once you get used to it, you'll find it easier to fall asleep!
    3. Supplements. There are some great supplements out there that can help support your adrenal function. Not everyone is right for every person, so it's best to work with someone who knows you to recommend the right herbs and nutrients exactly for you..


  • Exercise. 2 hours after waking, do 1-2 minutes of exercise to get the heart rate up. Could be anything that works for you, like running in place, up and down the stairs, or jumping in place. At this time in the morning, we should naturally have the most cortisol of the day.  If you feel tired mid-morning, try some movement instead of more coffee!   



Optimizing our body's natural rhythm to have healthy levels of cortisol in the morning and evening can be incredibly beneficial for both your overall fertility, health, and wellbeing!