Chronic Psychological Stress and Female Reproductive Dysfunction: Effects on Ovarian Reserve – A Narrative Review

Chronic psychological stress negatively affects systems including the female reproductive axis. Ovarian reserve, reflecting oocyte quantity and quality, is a determinant of fertility and reproductive aging. In contemporary society, uncertainty, economic instability, poor work-life balance, and expanding social roles of women contribute to delayed childbearing and attention to age-related fertility decline. This review evaluates the impact and long-term consequences of chronic psychological stress on ovarian reserve and reproductive aging in women. A narrative review was performed using PubMed and Scopus. The search included publications from the past 20 years on chronic psychological stress, ovarian reserve, ovarian dysfunction, premature ovarian insufficiency, and reproductive aging. Guidelines, original studies, and reviews were analyzed. Studies suggest that women exposed to chronic stress often report increased perceived stress before reproductive dysfunction appears. Clinical and demographic data indicate that chronic stress, emotional trauma, and major life events may contribute to ovarian dysfunction and act as triggers of premature ovarian insufficiency. These factors are associated with reduced ovarian reserve markers and hormonal changes, including altered AMH, FSH, and cortisol. Overall, evidence supports a possible link between chronic psychological stress and accelerated reproductive aging, although findings remain heterogeneous due to differences in study design, stress assessment, populations, and outcomes. Chronic stress appears to be associated with impaired ovarian function, decreased ovarian reserve, and earlier reproductive aging. These findings underline the need to identify at-risk women and integrate stress management, support, and preventive counseling into reproductive health care. Further studies are needed to clarify mechanisms, define biomarkers, and guide clinical practice.