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Endocrine Disorders

Endocrine disorders are some of the most common causes of infertility.

What is a hormonal imbalance?

The human body uses around fifty hormones to regulate different systems and bodily functions such as growth, metabolism, and temperature regulation. There are also a number of hormones that help regulate the development and release of the female reproductive cells (eggs). A hormonal imbalance can result from a change in the quantity of a hormone, its timing of release, interaction with other hormones, or the ability to act at the desired target usually via cellular receptors.

A number of lifestyle factors including diet, exercise, sleep patterns, stress, and exposure to environmental disruptive chemicals can influence hormone balances. An irregular balance of the hormones associated with reproductive health in one or both partners can make conception and pregnancy difficult. Hormonal imbalances are the leading cause of infertility in women and are often treatable with lifestyle changes and medications, but the impact on male infertility is not as well understood.

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How do hormones affect fertility?

Hormones play a pivotal role in female fertility and pregnancy, particularly those hormones that control the menstrual cycle. In order for a pregnancy to occur, hormones in the body must signal and regulate the growth of an egg within an ovary, the release of the newly formed egg into the fallopian tube, and thicken the uterine lining for implantation. If the newly released egg is fertilised by sperm (the development of sperm is also regulated by hormones within the male body), the resulting embryo will then travel to the uterus for implantation. An absence or irregular quantity of one or more hormones can delay or prevent any of the above processes from occurring, making it difficult to become pregnant.

Common causes of hormonal imbalance that affect ovulation

Some of the most commonly diagnosed conditions and hormonal imbalances are anovulation, polycystic ovary syndrome (PCOS), and hyperprolactinemia - an increase in the hormone prolactin. Diabetes and abnormal glucose metabolism, thyroid disorders, testosterone dysregulation, and body weight (rapid gain or rapid loss) all affect normal sperm or egg development and impact fertility.

Symptoms of hormonal imbalance in women

Quite often, hormonal imbalance is not diagnosed until an individual experiences infertility. However, women may experience one or more of the following symptoms:

  • Absent or irregular periods.
  • Spotting between periods.
  • Heavy or painful periods.
  • Increased hair growth on the face, neck, chest, and back.
  • Unusual breast discharge (galactorrhoea – usually due to high prolactin)
  • Unexplained weight gain / rapid weight loss.
  • Unexplained fatigue associated with thyroid dysfunction

Symptoms of hormonal imbalance in men

Men are less likely to have a hormonal imbalance that contributes to infertility than women, but they may still experience symptoms such as:

  • Erectile dysfunction / poor libido.
  • Low sperm count or quality.
  • Reduced body hair growth.
  • Breast tenderness and overdevelopment of breast tissue.

It’s important to discuss any of the above symptoms with a reproductive endocrinologist if infertility is suspected. You can make an appointment with Associate Professor Vasant Shenoy if you suspect you may have a hormonal imbalance that could be impacting your fertility.

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Testing for hormonal imbalance

Hormonal imbalances in men and women can be determined through appropriate history and simple clinical assessments including timed blood or urine analysis. Fertility hormone testing looks for the presence and timely action of a variety of hormones central to reproduction to determine if these are causing infertility and the appropriate treatment options.

Treatment for hormonal imbalance

Hormonal imbalance is usually treatable and should be treated whether or not you are trying to become pregnant. Treatments for hormonal imbalance may include medications to restore normal thyroid function, normalize hormone levels, induce ovulation, trigger a fully mature egg or improve sperm counts.

Lifestyle modifications, such as weight loss or diet changes can also normalize hormone levels and improve the chances of pregnancy. See our e-book on Boosting Your Natural Fertility for tips and advice on nutrition and lifestyle changes that can improve fertility.