Psychological stress may affect brain function and biological clock resulting in disturbance of hypothalamo-pituitary control of hormone production. The effect on the brain is ultimately manifested in other organs owing to hormonal regulation through hypothalamo-pituitary axis. This disturbance in hypothalamus–pituitary–gonadal axis may adversely affect spermatogenesis (29). There have been several reports linking male infertility to stress (5). Cortisol is the hormone produced in response to stress (8), and increased level of cortisol may reduce the functional activity of LH, thereby reducing testosterone level (30). Psychological stress leads to low testosterone levels due to reduction in LH pulse frequency. Reduced testosterone level in turn reduces libido and leads to oligospermatogenesis (31). The reduction of stress level and improvement in male factor fertility as a result of treatment with W. somnifera, offer direct evidence in favor of stress as a cause of male infertility.
