The dynamic interplay between women’s stress and reproductive axes across reproductive transitions: post-partum amenorrhea, the resumption of ovarian cyclicity and early pregnancy

Stress is often cited as having negative effects on women’s health. Most research, however, does not adequately account for the changes in stress physiology women experience as they transition between key reproductive phases (post-partum amenorrhea, resumption of ovarian cyclicity, and pregnancy). Reproductive function is modulated by the HPG (hypothalamic-pituitary-gonadal) axis, while stress response is controlled by the HPA (hypothalamic-pituitary-adrenal) axis. These two axes overlap and interact in manner a that affects both reproductive function and stress.

Dr. Pablo Nepomnaschy’s research focuses on investigating the relationship over time between the HPA and HPG axes. Understanding this relationship is paramount to all research focused on how stress affects women’s health and reproduction and their children’s development. The aims of this research are to: 1) produce the first longitudinal description of stress and reproductive hormones for healthy women as they transition across reproductive phases; 2) study the dynamic interactions between the HPA and HPG axes across those phases; 3) evaluate the role of psychosocial, energetic, and health stressors as modulators of reproductive transitions and the effect these transitions have on the physiologic responses to those stressors; 4) conduct an exploratory pilot study of the effects that peri-conceptional stress has on the development of the HPA axis in children.

Nepomnaschy will use data and bio-specimens from British Columbian and Guatemalan women and children. The socio-economic and ethnic homogeneity of the Guatemalan population provides a unique opportunity for the development of a basic model of the longitudinal relationship between the HPA and HPG axes. Those results will be used to develop studies to investigate stress-related health outcomes for women and children in BC, particularly among disenfranchised groups facing higher risk of stress exposure, such as BC’s Aboriginal population, new immigrants, and the homeless.