First of All, What are Adverse Childhood Experience or ACEs?
Adverse childhood experiences, also referred to as early life stress and childhood trauma, include any event that takes place before the age of 18 that chronically activates your stress response. This may sound complicated, but if you’ve ever heard of the “fight or flight” response, you’re actually already familiar with the concept of the stress response. What we call the “fight or flight” response is the acute portion of the stress response. In other words, when we are exposed to a short-term stressor like almost being hit by a car or like someone scaring you as you walk in the dark, our acute stress response or “fight or flight” response is activated. In these examples, we come into contact with the stressor and then it resolves and our bodies return to their normal state. On the other hand, when we are exposed to a chronic stressor, specifically a stressful experience that either happens repeatedly or causes us to relive the encounter in our minds repeatedly, the chronic arm of our stress response is activated. This is more of a long-term occurrence.
In short, any event that activates this chronic arm of the stress response during childhood counts as an ACE. Here is a list of the most commonly studied and referenced adverse childhood experiences:
- your parents being separated or divorced;
- living with someone who is experiencing depression or another mental health concern;
- having someone in your household go to jail or prison;
- living with someone who struggles with addiction;
- seeing your mother or another household member treated violently;
- experiencing sexual, physical, or emotional abuse;
- feeling like you’re not loved or protected at home;
- and not having enough clothing, food, shelter, or means to obtain necessities during childhood.
Aside from those commonly researched ACEs, researchers have also looked at connections between chronic health concerns and other forms of trauma, such as:
- growing up in foster care,
- losing a parent or sibling to death,
- being chronically ill during childhood,
- and more.
When we experience these types of traumatic events before the age of 18, the mechanism that controls our stress response can become hyperactive, making it more likely that we’ll have poor health as adults and that we’ll be diagnosed with many different chronic conditions. This includes reproductive concerns like pre-menstrual syndrome (PMS), polycystic ovarian syndrome (PCOS), fibroids, endometriosis, and infertility or otherwise impaired fertility.
Take the ACE assessment to find out your ACE Score and what you can do to reduce your health risk!
How Do Adverse Childhood Experiences Increase Our Risk For Hormonal Concerns like PMS, PCOS, Fibroids, Endometriosis, & Infertility?
To understand the connection between our reproductive hormones and childhood trauma, we need to talk a bit more about the chronic arm of the stress response. This portion of your stress response is controlled by what is called the hypothalamic-pituitary-adrenal (HPA) axis. Essentially, when we are exposed to a chronic stressor, a portion of the brain called the hypothalamus sends a hormonal messenger (called corticotropin-releasing hormone or CRH) to the pituitary gland, which is also located in the brain. In response, the pituitary gland then sends a different hormonal messenger to the adrenal glands, which are located directly above your kidneys. This hormonal messenger, referred to as adrenocorticotropic hormone or ACTH, then causes the adrenal glands to secrete hormones, most notably the stress hormone cortisol. When we experience adverse events during childhood, our HPA axes tend to initially become hyperactive, leading to high levels of these stress-related hormones in our systems. Because our brains and bodies are still developing during childhood and are therefore vulnerable to change, this increase in stress hormones actually resets our baseline or normal level of stress hormones. We develop a new, higher normal. We refer to this new “normal” as HPA axis hyperactivity. This hyperactivity leads to us having exaggerated physiological responses to stress and, in many cases, this hyperactivity continues into adulthood.
The hypothalamus and pituitary glands do more than secrete CRH and ACTH in order to activate the stress response. In fact, they’re responsible for releasing quite a few other important hormones. The hypothalamus, for example, also releases gonadotropin-releasing hormone or GnRH. GnRH then travels to the pituitary gland and causes it to release hormones called luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH are extremely important to our discussion on reproductive hormones because they act on our ovaries to increase the production of some important reproductive hormones, such as estrogen and progesterone. Similar to the HPA axis, we refer to this cascade of events that takes place with the hypothalamus, pituitary gland, and ovaries as the hypothalamic-pituitary-gonadal or HPG axis.
Here’s how childhood trauma and our reproductive hormones are connected: the HPA axis, which controls the chronic arm of the stress response, has complex effects on the HPG axis. For example, the HPA axis hormone CRH inhibits or blocks the HPG axis hormone GnRH, so that when CRH levels are high, such as is the case for many women who have experienced childhood trauma and have developed a hyperactive HPA axis as a result, GnRH levels are low. When GnRH levels are low, LH and FSH levels are also low and we see abnormalities in our other hormone levels like estrogen and progesterone as well (think PMS, fibroids, endometriosis, etc.). In women, abnormal LH and FSH levels are associated with irregular or absent menstrual cycles (think PCOS) and infertility.
So essentially, childhood trauma can lead to hyperactivity of the HPA axis which then results in unwanted changes to the HPG axis. These HPG axis changes then lead to problems with our reproductive function and this can manifest as pre-menstrual syndrome (PMS), polycystic ovarian syndrome (PCOS), fibroids, endometriosis, or impaired fertility.
Take the ACE assessment to find out your ACE Score!