Study links post-traumatic stress disorder and anxiety to lower ovarian reserve in female firefighters

A new study led by University of Arizona Mel and Enid Zuckerman College of Public Health researchers in collaboration with fire department partners and other researchers from across the country as part of the Fire Fighter Cancer Cohort Study finds that post-traumatic stress disorder and anxiety are associated with lower levels of the level of anti-Müllerian hormone, a marker of ovarian reserve, among female firefighters.

Ovarian reserve is the number of healthy eggs in a woman’s ovaries that can potentially be fertilized. It is a measure of a woman’s fertility and her ability to have children.

“These findings highlight the negative impact that mental health problems can have on health – particularly reproductive health,” said first author Michelle Valenti, MPH, a doctoral student in epidemiology at the Zuckerman College of Public Health and coordinator of the Fire Fighter Cancer Cohort Study of Women Firefighters .

The article, “Evaluating the Effect of Depression, Anxiety, and Post-Traumatic Stress Disorder on Anti-Müllerian Hormone Levels Among Women Firefighters,” was published in the Journal of Women’s Health.

In addition to chemical exposure, firefighters are exposed to high stress and traumatic situations and have a higher incidence of post-traumatic stress disorder (PTSD) compared to the general population. Previous research has shown that female firefighters have lower levels of anti-Mullerian hormone compared to women who are not firefighters; however, the reason was unknown.

The research team, which included staff from the Center for Collaborative Research on Firefighter Health at the Zuckerman College of Public Health, conducted this analysis to determine whether anxiety, depression, or post-traumatic stress disorder (PTSD) were related to anti-Müllerian hormone levels. They found that clinical diagnoses of PTSD and anxiety were associated with reductions in anti-Müllerian hormone levels by 66% and 33%, respectively.

These findings highlight a potential mechanism by which adverse mental health conditions may lead to adverse reproductive outcomes. Further research is needed to identify potential areas for intervention.

The work of this AMH study in the broader context of FFCCS is essential to ensure care for all of our firefighters. These findings provide fire departments with scientific leverage to implement programs that reduce stress and improve the lives of our firefighters.”

Captain Caitlin St. Clair of the Puget Sound Regional Fire Department

The Women Firefighter Study, a subset of the Fire Fighter Cancer Cohort Study, aims to identify the causes of stress, cancer and adverse reproductive health outcomes in women firefighters so that effective interventions can be implemented to mitigate these conditions.

“This study demonstrates the effectiveness of the Women’s Firefighter Cancer Cohort Study in assessing exposures leading to adverse gynecological conditions,” Valenti said. “The Women Firefighter Study would not be possible without our incredible fire service partners who have supported research on women firefighters.”

Co-authors from the Zuckerman College of Public Health include senior author Jeff Burgess, MD, MPH, professor and director of the Center for Firefighter Health Collaborative Research at the U of A Mel and Enid Zuckerman College of Public Health and a member of the BIO5 Institute; Leslie Farland, ScD, Associate Professor and BIO5 Institute Fellow; Dr. Yiwen Liu, assistant professor of epidemiology and biostatistics; Shawn Beitel, administrator of the firefighter research program; research technician Jordan Baker; and graduate Kaiwen Huang.

Apart from St. Claire, other fire department research staff who contributed to the study include Captain John Gulotta of the Tucson Fire Department, Captain Jamie Kolar and Dr. Derek Urwin of the Los Angeles County Fire Department, and many other firefighters.