Hormonal imbalance key concepts
- The correct balance of hormones, which are created by the glands of the endocrine system, is necessary for proper functioning of the reproductive system.
- Hormonal imbalances are a leading cause of infertility in women and can also cause or contribute to infertility in men.
- In women, reproductive hormone imbalance can cause anovulation (lack of ovulation) and conditions such as polycystic ovary syndrome (PCOS), both resulting in infertility.
- Symptoms can include heavy, absent or irregular periods in women and erectile dysfunction and low sperm counts in men.
- Lifestyle modifications and medications are the primary treatment for hormone imbalances depending on the degree of imbalance.
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What is a hormonal imbalance?
Eight glands in the body make up the endocrine system, releasing many hormones that send signals through the blood to organs and other tissues. Several of these hormones have a direct effect on the reproductive system. When these hormones are out of balance, they can cause difficulty conceiving and infertility.
These hormones (see the list below) can affect each other and regulate efficient reproductive functions. When there is too little or too much of one or more of these hormones – in one or both partners – reproduction ability can suffer. Imbalances can also influence other bodily functions such as metabolism, growth and mood.
Board certified in reproductive endocrinology & infertility (REI), our fertility specialist Dr. Isaac Glatstein is uniquely trained in managing the hormonal imbalances that can occur in the endocrine system and impair fertility in both women and men.
How does a hormonal imbalance affect fertility?
Hormone effects on infertility in women
The most common symptom of an imbalance of hormones causing infertility in women is ovulation dysfunction, although other systems may be impacted causing weight gain, increased hair growth or acne. Several hormonal issues can hamper efficient ovulation, which is the release of a mature egg once a month or stop it altogether.
Hormonal signals regulate the growth and maturation of an egg in the ovary during the luteal phase just before ovulation. Improper amounts of the hormone progesterone can shorten this luteal phase, impeding implantation and a healthy pregnancy. Hormones also affect ovulation (release of the egg) for possible fertilization as well as helping prepare the uterine lining for implantation of a subsequent embryo. PCOS is one hormone-related condition that affects ovulation.
Additionally, hormone imbalance also affects the menstrual cycle, which can directly impede ovulation. Irregular periods can make it challenging to predict when ovulation is occurring, which is the best time to have intercourse to achieve pregnancy.
Related reading: How an irregular menstrual cycle affects fertility
Hormonal imbalances and male infertility
The production of healthy sperm can be diminished by hormonal issues. This can result in fertilization failure. Several hormones help regulate sperm production, and these hormones can have effects on each other. Follicle-stimulating hormone (FSH) works with luteinizing hormone (LH) for sperm production, and LH triggers testosterone production.
Testosterone plays a key role in male reproductive capabilities. Along with other hormones it helps the body create the proper quantity and quality of sperm needed for efficient fertilization. Produced in the testicles, testosterone helps the growth of male sex organs and contributes to a man’s sex drive, which has a bearing on ability to conceive. Low testosterone can cause erectile dysfunction.
Symptoms of hormone imbalance
Symptoms vary by the hormones involved. For women, symptoms can include:
- Irregular periods and spotting between periods.
- Unexplained weight gain.
- Acne.
- Mood swings.
- Infertility.
- Hair loss.
Primary symptoms of hormone imbalance in men:
- Erectile dysfunction.
- Loss of interest in sex.
- Loss or thinning body hair.
- Infertility.
Symptoms may or may not be present. While it is good to be aware of potential signs, noticing them is not enough to know that one has a hormonal issue. Professional evaluation is needed.
About Dr. Issac Glatstein
- Dr. Glatstein is an expert in endocrine disorders like hormone imbalances and earned his REI certification at Harvard.
- He has successfully treated many individuals and couples experiencing infertility due to these endocrine problems.
- He and the entire Conceive NJ staff place the patient’s experience at the center of all decisions and care.
- The physical practice and laboratories are state-of-the art and, Conceive NJ’s people are highly trained and motivated to provide the best outcomes in hormone treatment.
- Conceive NJ has its own in-house hormone laboratory, with leading edge technology, providing rapid and accurate endocrine hormonal measurements.
What causes hormonal imbalance?
Hormonal imbalances can stem from a variety of factors that disrupt the endocrine system’s ability to regulate hormone levels. Most people will experience natural periods of hormonal fluctuations at certain life stages, such as puberty, pregnancy and menopause. However, when the endocrine glands are not functioning properly, these imbalances can become more pronounced and problematic.
Medical conditions cause a lot of hormone imbalance issues. These include PCOS, primary ovarian insufficiency, diabetes among others. Adrenal disorders, insulin resistance (often due to PCOS) and testosterone disorders in men due to genetics, infections and injury can also cause hormone balance issues. Tumors, cancers, endocrine gland damage and aging, particularly in women, can alter hormone levels.
Thyroid conditions can cause fertility problems if thyroid hormone production is either under or overactive. All patients are evaluated for possible thyroid disorders, which are critical for a normally-functioning reproductive system as well as a healthy pregnancy. Additional important hormones include prolactin, which can result in hypothalamic dysfunction, hyperprolactinemia (excess prolactin) or hypogonadism (low testosterone).
Medical treatments can affect reproductive hormone levels. Radiation, chemotherapy, immunotherapy and surgery can alter hormone levels. Medications can as well, including psychiatric medication like antidepressants, steroids and thyroid medications.
Lifestyle factors patients can help change are another cause of hormonal issues affecting fertility. These include being underweight or overweight, excessive exercise, stress, substance abuse and poor sleep hygiene.
Chemicals in foods and the food industry result in endocrine disrupters that affect hormone levels, which is a growing concern. According to the National Library of Medicine, endocrine disrupters are associated with conditions such as PCOS, endometriosis and irregular periods affecting female fertility.
Primary hormones affecting fertility
Approximately 50 hormones play various roles in regulating functions. Following are the primary ones affecting fertility in men and women.
- Estrogen: Produced by the ovaries, estrogen regulates the menstrual cycle and prepares the uterine lining for embryo implantation. An estrogen imbalance impedes ovulation.
- Progesterone function: Progesterone also prepares the uterine lining for pregnancy and promotes early pregnancy. Too little can also hinder conception.
- Luteinizing hormone: Luteinizing hormone (LH) helps initiate ovulation in women and aids in testosterone production in men for sperm health.
- Follicle-stimulating hormone: Follicle-stimulating hormone (FSH) plays a major role in the development of ovarian follicles, which affect menstruation and release an egg in ovulation. In men, FSH stimulates sperm production.
- Anti-Müllerian hormone: Anti-Müllerian hormone (AMH) is a primary marker for a woman’s ovarian reserve, which is the remaining eggs she has left. We often measure AMH to evaluate fertility potential.
- Testosterone: Testosterone is a key to male reproductive health, sperm production and sex drive (libido). In women, testosterone plays a role in ovarian function.
- Gonadotropin releasing hormone (GnRH): This hormone stimulates production of LH and FSH. GnRH initiates necessary hormone activity that affects female ovulation and male sperm production.
- Human chorionic gonadotropin (hCG): This supports progesterone production during pregnancy, helping to prevent miscarriage.
- Prolactin: Imbalance of prolactin can disrupt ovulation and cause irregular menstrual cycles.
- Thyroid hormones: Several thyroid hormones created by the thyroid gland affect reproductive functioning of the ovaries and uterus.
Infertility treatments for hormonal imbalance
First, we arrive at a diagnosis of a hormone disorder affecting fertility. Blood and urine tests may reveal the presence of the imbalance in hormones, including which ones and whether they are at a low or high level. Understanding this helps us in determining a potential cause such as PCOS and thyroid issues.
Knowing the cause helps guide treatment. Medications are the primary means of treatment. These can adjust particular hormone levels such as FSH and LH. Medications can also address thyroid functioning and can be used to stimulate ovulation.
Most women and men with hormone level issues can still get pregnant with treatments. But they must be evaluated to determine the issue of their difficulty conceiving in order to get the appropriate treatment. Because age in women increases the risk of improper hormone balance, seeking evaluation soon is the best step. Medical treatment can also help reverse infertility in men due to hormone issues.
In summary, a thorough reproductive hormonal evaluation is one of the cornerstones of a complete fertility evaluation. At Conceive NJ we place this at the front and center of our Diagnostic Cycle where we can diagnose and treat many hormonal disorders responsible for fertility problems.