Did you know that the hormones surging through your body influence or even control many of the most important bodily processes—including the ability to get pregnant? Because you can’t see or consciously adjust the levels of these critical compounds, it can be profoundly frustrating when you find yourself struggling to conceive if you suspect that a hormone irregularity may be at play.
“As stressful and upsetting as it may be, it’s important to remember that 1 in 8 couples of reproductive age will experience difficulty conceiving. And, in many of these cases, hormonal imbalances are at least part of the problem,” remarks board certified reproductive endocrinologist Rachana Garde, M.D., of SGF’s Woodbridge and Annandale, VA locations.
Whether you’re just setting off on your journey towards conception, or you’ve been trying for a while now, knowing better how your hormones impact fertility—and what you can do to minimize or eliminate issues—is a wise step.
1) WHICH HORMONES HAVE AN IMPACT ON FERTILITY?
“While a few hormones seem to be named more often than others when it comes to pregnancy, the truth is that many come into play. In fact, the number of different hormones that impact fertility is one of the things that can make addressing hormone-related infertility particularly challenging. However, the good news is and what I tell my patients, in many cases, we can make the right adjustments to properly balance hormones, which will ultimately lead to easier conception,” adds Dr. Garde.
Some of the hormones that will most significantly impact your ability to become pregnant are:
Thyroid hormones – There are lots of hormones produced by the thyroid, most notably triiodothyronine (T3) and thyroxine (T4) hormones. These hormones primarily impact metabolic rate and digestion, but they are also inextricably tied to reproduction. If you’re experiencing thyroid dysfunction, you may experience difficulties, including hyperprolactinemia.
Prolactin – The hormone prolactin is critical to the production of breast milk, but it also plays an essential role in becoming pregnant in the first place. If your prolactin levels are abnormal, you will likely experience cycle irregularity, which in turn can cause issues with ovulation and, ultimately, with conception.
Anti-Müllerian Hormone (AMH) – This hormone is produced by ovarian follicles, or the sack that contains the immature egg. Its primary function is to support the immature eggs. Measuring this hormone is one of the best predictors of how many eggs you have remaining in your ovaries.
Follicle-Stimulating Hormone (FSH) – This hormone is directly linked to fertility, as its key function is to help regulate the menstrual cycle and induce the production of eggs in the ovaries. Women who have a loss of ovarian function often have higher FSH levels, as their bodies are trying to compensate for this dysfunction.
Luteinizing Hormone (LH) – This hormone signals the body to release a mature egg. Ovulation predictor kits depend on the measurement of this hormone, as levels generally surge immediately before ovulation.
Progesterone – This hormone is essential to maintaining a pregnancy. Progesterone helps thicken the uterine lining, which in turn helps support an embryo. Women with low progesterone levels often experience recurrent miscarriages.
2) WHAT ARE COMMON SIGNS OF A HORMONAL IMBALANCE?
The most common signs of hormonal imbalance in women include:
Menstrual cycle irregularity
Spotting or irregular bleeding
New or worsening acne
Male-pattern body hair
Male-pattern hair loss
Unexplained weight gain
Extreme mood changes
“What I always caution my patients, every woman is different. While some who have a hormonal imbalance will not show any outward signs, the majority do have one or more symptoms. It’s important to never use the presence or absence of one or more these signs to self-diagnose. Bring us your concerns, and let’s talk about it,” adds Dr. Garde.
3) WHAT CAUSES A HORMONAL IMBALANCE?
The two most common causes of fertility-related hormonal imbalance are thyroid dysfunction and polycystic ovary syndrome (PCOS). Either condition can make getting and staying pregnant without medical intervention more difficult.
4) HOW CAN A HORMONAL IMBALANCE IMPACT MY FERTILITY?
With so many different hormones impacting your ability to conceive and maintain a pregnancy, it becomes easier to understand that a hormonal imbalance can cause an equal array of fertility challenges.
Two of the most common fertility issues linked to hormonal imbalance are:
Ovulatory Dysfunction – A number of hormone-related abnormalities, including irregularities in thyroid hormones and polycystic ovary syndrome (PCOS), can decrease the regularity of ovulation or prevent it altogether. When ovulation is interrupted, becoming pregnant is unlikely, as there is no egg to fertilize.
Short Luteal Phases – The luteal phase is the time period that immediately follows ovulation. The length of this phase is controlled by progesterone, the hormone that maintains the thickness and strength of the uterine lining. The average luteal phase is 13 to 14 days. “If you have a luteal phase shorter than 10 days, a fertilized embryo may not be able to implant, preventing pregnancy, and we recommend you come in for a simple fertility evaluation,” says Dr. Garde.
5) WHAT INFORMATION WILL A DOCTOR NEED TO HELP RESOLVE HORMONAL IMBALANCES AND INCREASE MY LIKELIHOOD OF GETTING PREGNANT?
“The best thing you can do if you think you may have a hormonal imbalance, is to begin tracking your cycles and schedule a simple fertility evaluation with a specialist. For tracking, you can do this either through the use of a traditional calendar or a specialized app, like Glow. Information about the length of your cycles will help your doctor begin to confirm or rule out the presence of a hormone irregularity, as cycle irregularity is the most common sign of a hormonal imbalance (though not the only one),” says Dr. Garde.
Garde adds, “You can also also use ovulation predictor kits (OPKs) to determine when in your cycle you are ovulating. However, for some women with hormonal imbalances—like those with PCOS—these tests don’t yield useful information, so beware.”
Some women elect to chart their basal body temperature, which generally rises in accordance with ovulation. “While you can use this method, we don’t generally recommend it. It’s tedious and yet, for all of the effort, often doesn’t provide much useful information,” says Dr. Garde.
6) ARE HORMONE LEVELS IMPACTED BY AGE?
“Yes, definitely. As you age, many fertility-related hormone levels change substantially. FSH, in particular, commonly increases as women start to have decreased ovarian function with age. AMH levels also change substantially, decreasing as you age as the number of eggs remaining in your ovaries decreases. Because fertility potential is impacted most by a woman’s age, we strongly encourage early intervention to increase your chances of pregnancy,” explains Dr. Garde.
7) COULD IT BE THAT CHANGES IN MY MENSTRUAL CYCLE ARE JUST THE START OF MENOPAUSE?
“Without a doctor’s support, it’s difficult to determine whether cycle irregularities approaching the end of your childbearing years are the start of menopause. Women in pre-menopause (known as perimenopause) often start to experience cycle changes in which their cycles change in length or, in some cases, stop altogether. The best way to determine whether menopause is in play is to seek the help of a fertility specialist. We can use bloodwork to determine your ovarian status and determine whether conception is still possible,” adds Dr. Garde.
8) SHOULD I SEEK MEDICAL ATTENTION FOR A HORMONAL IMBALANCE EVEN IF I’M NOT TRYING TO GET PREGNANT?
“Definitely, yes. Hormones impact much more than your reproductive system. Even if you’re not currently pursuing parenthood, it’s important to see a doctor if you suspect a hormonal imbalance,” says Dr. Garde.
9) HOW DO YOU TREAT HORMONAL IMBALANCES IF I’M TRYING TO GET PREGNANT?
There are various ways we can treat a hormonal imbalance and increase the likelihood of conceiving and maintaining a pregnancy. Treatments for hormonal imbalances are highly customized, as each hormonal imbalance is different. Medication is commonly used to:
Restore thyroid function
Normalize prolactin levels
If you’re having difficulty as a result of your hormonal imbalance, contact Dr Sandra DeCarlo.
Credit: Shady Grove Fertility