The Physical Impact of Stress

We're built to handle stress in small doses. However, severe, long-term or chronic stress can physically affect your body. Justin Houman, M.D., a reproductive urologist and men's health specialist at Tower Urology in Los Angeles and the medical director for Bastion Health, an app-based telehealth platform for men, said stress can impact several different systems in the body, causing a variety of symptoms:

• Cardiovascular system. Stress can cause an increase in heart rate and blood pressure, leading to an increased risk of heart attack, stroke and other cardiovascular problems.
• Digestive system. Stress can cause nausea, stomach pain, diarrhea, constipation and other digestive problems.
• Endocrine system. Stress can cause the release of hormones such as cortisol, which can lead to weight gain, decreased immune function and other health problems.
• Immune system. Chronic stress can weaken the immune system, making it more difficult for the body to fight off infections and illnesses.
• Muscular system. Stress can cause muscle tension, pain and stiffness, leading to headaches, backaches and other types of pain.
• Reproductive system. Stress can affect hormone levels and cause menstrual irregularities, decreased libido and other reproductive problems.
• Respiratory system. Stress can cause shallow breathing, chest tightness and hyperventilation, leading to panic attacks and other respiratory problems.

Alexander Knezevic, M.D., a board-certified ophthalmologist at the Macy Eye Center in Los Angeles, noted a lesser-known eye problem is also stress-related.

"There is an eye condition called central serous retinopathy typically caused by stress," he said. "Patients will notice blurry vision or a fixed blurry spot in the vision."

Knezevic said an eye and retina exam is needed to confirm the condition.

In addition to the effect stress can have on all of these body systems, there are problems specific to both men and women that can be related to stress.

In men, Houman said stress could cause physical and emotional changes that lead to erectile dysfunction (ED), making it difficult to achieve or maintain an erection. Stress and anxiety can also cause premature ejaculation, which in turn can affect sexual satisfaction.

Three very common causes of ED are stress, tiredness and alcohol consumption, so it should be noted that there can be more than one factor involved.

"Men may be more likely to turn to alcohol or drugs as a way to cope with stress, which can lead to addiction and other health problems, like ED," Houman said.

Chronic stress can cause hair loss (in men and women), but it can particularly affect men who are already genetically predisposed to balding. Stress-related hair loss tends to be temporary but can be very distressing at the time. There is also a condition called trichotillomania, which is a compulsive urge to pull out your own hair, usually triggered by stress.

Heart disease is a leading cause of death in men, and Houman emphasized the importance of men being aware that stress can increase the risk of heart disease.

Men and women often react to stress differently, which can be displayed differently in their emotions and reactions.

"Men may be more likely to express stress through anger and irritability, which can lead to problems in relationships and at work," Houman said.

It's essential to recognize if stress negatively impacts your home or work life and take steps to try to reduce your stress levels.

The Office on Women's Health, a U.S. government agency, reports that studies show women are more likely than men to experience stress symptoms, anxiety and depression. The reason women and men react differently to stress is largely unknown, but it's thought to be related to how men's and women's bodies process stress hormones.

"Women are more likely than men to experience depression and anxiety, and stress can be a major contributing factor," Houman said, adding that women also may be more likely to turn to food as a way to cope with stress, which can lead to the development of eating disorders such as anorexia or bulimia.

Changes in eating patterns are just one indicator that stress may be a problem.

Houman advised that there are specific physical problems women can experience due to stress, such as:

• Breast cancer. Studies have suggested a link between stress and an increased risk of breast cancer in women.
• Fertility problems. Chronic stress can interfere with ovulation and fertility, making it more difficult for women to get pregnant.
• Menstrual irregularities. Stress can disrupt the menstrual cycle, leading to irregular periods, heavier or lighter bleeding and other menstrual problems.
• Pregnancy complications. High stress levels during pregnancy can increase the risk of complications such as premature birth, low birth weight and preeclampsia.

A 2010 report on stress and gender carried out by the APA found women are more likely to report physical symptoms associated with stress. However, it also found women are better at making strong connections with others, and these connections are essential to their stress management strategies.

We've mentioned ED and premature ejaculation, but there are other sexual health issues related to stress.

Alexis Powell-Howard, M.A., psychotherapist, TEDx speaker and managing director at Fortis Therapy in Lincolnshire, England, said stress can impact sexual health in a variety of ways and even lead to a negative relationship with sex.

"Interest in physical intimacy, on the whole, can often suffer due to stress, as well as the psychological side of sexual intimacy," she explained. "Stress can reduce motivation, energy and desire, and can cause low feelings, which in turn can make us avoid intimacy."

This avoidance and the distance created might make sexual intimacy difficult or even unattainable, and any sex that does occur may be an unpleasant experience, she added.

"For women, stress can decrease vaginal lubrication, making intercourse uncomfortable or painful," Houman said. "Muscle tension caused by stress can lead to pain during sex, especially for women."

Conversely, Powell-Howard said sex might be used as a distraction technique by people trying to either avoid confronting the cause of their stress or dull the negative feelings caused by their stress.

"Again, this may spark a negative relationship with sex and self-esteem, even past the stressful period," she said.

If left untreated, stress can impact your entire life, Houman reiterated. Physical implications include cardiovascular disease, digestive issues, sleep disorders, a weakened immune system, and all the physical and sexual health problems previously mentioned. In some cases, these conditions can be long-lasting and may lead to further concerns, such as substance abuse, which can lead to addiction and other health problems.

"The implications of stress are obviously challenging, but it can often be more difficult to accept the stress feelings we have, with physical symptoms recognized and treated separately," Powell-Howard said.

She added that it's essential to keep an eye on the physical signs, assess the stress you're under and treat it accordingly to avoid long-lasting damage.