Fertility issues are a growing concern among women, especially in the western world. As infertility levels climb so do the growing number of women with hormonal disorders. Part of the role of a naturopathic doctor is to determine which hormonal disorder, if any, are causing fertility issues.
There are five main hormonal disorders that need to be assessed any time women have issues with fertility. They are PCOS, endometriosis, luteal phase deficiency, premature ovarian insufficiency, and hypothyroidism.
1) Polycystic Ovarian Syndrome (PCOS)
PCOS is a hormonal disorder that primarily causes issues with hormonal signals leading to anovulation. Women with PCOS often present with acne, unwanted hair growth, hair loss, irregular cycles, and/or cysts on their ovaries. A lack of ovulation and inappropriate hormonal responses cause issues with fertility and miscarriage risk.
2) Endometriosis
Endometriosis is a complex disorder that causes the growth of uterine tissue outside of the uterine cavity. This results in pelvic pain ranging from mild to severe. Women often notice pain while having sex, pain while having a bowel movement, pain while urinating, pain during their periods, pain during ovulation, and so on. The structural changes that occur in the pelvic area due to the inappropriate growth of tissue causes issues with fertility.
3) Luteal phase deficiency
The luteal phase is the second half of the cycle after ovulation where progesterone is produced. Increasing age, inappropriate calorie consumption, stress, and/or excessive exercise can cause issues in progesterone production. Women will often notice cycles that are <21 days or >35 days long, spotting before periods, spotting between cycles, and/or breast tenderness. Luteal phase deficiency can cause issues with fertility as it can change the timing of ovulation and increase the risk for miscarriage.
4) Premature ovarian insufficiency (POI)
Premature ovarian insufficiency occurs when ovarian reserve starts to decline before the natural age of menopause. This can occur due to auto-immune disorders, medications, previous viral infections and/or genetics. The declining ovarian reserve means that there are fewer eggs and less chances of getting pregnant. Women with POI will often notice hot flashes, vaginal dryness, mood changes, and menstrual irregularities.
5) Hypothyroidism
Hypothyroidism occurs when the thyroid is underactive and does not produce the necessary amount of thyroid hormones. This impacts many different areas in the body including the ovaries. Women with hypothyroidism will often present with weight gain, hair loss, dry skin, cold intolerance, constipation, and/or menstrual irregularities. This condition impacts fertility as it increases the risk for miscarriage and menstrual irregularities.
When trying to get pregnant, its important to have a thorough assessment to determine the hormonal barriers that are impeding pregnancy. Then using the many tools that are available in the naturopathic toolkit we work to help balance hormones, optimize fertility, and improve fertility success.
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