HORMONAL IMBALANCE AND INFERTILITY (Part 2)

Last week, we started a discussion on hormones and their effects on fertility. We listed an explained some of the hormones found in women and their impacts on the reproductive system. This week, we will further discuss more types of female hormones, causes of imbalances, signs and diagnosis of hormonal imbalance.

• Anti-Mullerian Hormone (AMH): This hormone is produced by the growing ovarian follicles that contain immature eggs. It determines ovarian reserve (that is, the level of this hormone is used to predict the number of eggs remaining in the ovary). Reduced level of AMH can point to low ovarian reserve or early menopause depending on the age while an elevated AMH points to polycystic ovarian syndrome (PCOS).

• Testosterone: This hormone is produced by the pre-antral follicles in the ovaries and supports the increase in estrogen during the follicular phase. If excess testosterone is produced, it promotes abnormal growth of early follicles which can lead to polycystic ovaries. If the level of testosterone is low, the follicles might not be growing at all or it could be a case of primary ovarian insufficiency or low ovarian reserve.

• Thyroid Hormones: The thyroid hormones include TSH, T3 and T4. All three hormones play a vital role in fertility. TSH stimulates the production of T3 and T4 while T3 and T4 produced impact the amount of estrogen and progesterone released each cycle. This means if there is a problem with the thyroid, the whole menstrual cycle will be affected. Hyperthyroidism (excessive production of thyroid hormones) disrupts the entire reproductive cycle while hypothyroidism (inadequate production of thyroid hormones) causes prolong periods and can also affects weight, muscle health of an individual. 

• Prolactin: This hormone is responsible for production of breast milk. It also plays a role in helping women get pregnant. If the levels of prolactin are fluctuating irregular periods will occur and there will be ovulation problem leading to infertility.

CAUSES OF HORMONAL IMBALANCE IN WOMEN

Some of the causes of hormonal imbalances in women that can cause infertility or difficulty in getting pregnant include the following;

• ANOVULATION: This is a condition where a woman does not ovulate.

• POLYCYSTIC OVARIAN SYNDROME: This is when hormonal disorder causes the eggs to stay immature and turns into cysts making it difficult to get pregnant and also causes infertility.

• HYPERPROLACTINEMIA: In this condition there is excess of prolactin in the body, causing the body to have irregular periods and eventually infertility.

• POOR DIET: A poor diet can cause hormonal imbalance because eating a lot of foods high in simple carbohydrates and sugar can raise cortisol levels in the body and high cortisol levels can have an effect on the amount of progesterone produced, also reducing calories too much causes a decline in hormones which is enough to cause an imbalance in women and disturb the menstrual cycle.

• OVER-EXERCISING: Exercising is good for the body and mind. But strenuous exercise can cause a reduction in hormones, especially estrogen.

• AGING: As a woman ages or approaches menopause, her hormone levels fluctuate and gradually decline, estrogen and progesterone the two main hormones produced during menstrual cycle declines drastically which causes symptoms like hot flashes, trouble sleeping and weight gain.

• STRESS: When the body is stressed it produces cortisol, long term stress exposes the body to high levels of cortisol which causes Cushing syndrome and can affect the levels of other hormones in the body.

• CHEMOTHERAPY: Chemotherapy can be lifesaving but while the drug kills cancer cells, it may also have an effect on other cells in the body. Depending on the chemo administered it can cause the ovaries to stop producing hormones, which leads to medical menopause.

• THYRIOD DISORDERS: such as hypothyroidism (reduced thyroid hormones) hyperthyroidism (increased thyroid hormones), and hyper functioning thyroid nodules causes hormonal imbalance as these hormones regulate the menstrual cycle. Hence any alteration will lead to an imbalance.

• BLOOD SUGAR ABNORMALITIES: such as hyperglycemia (excess of glucose in the blood) can lead to excessive production of estrogen and testosterone which causes polycystic ovarian syndrome (PCOS) while hypoglycemia (reduced glucose in the blood) can lead to low estrogen level which is mostly seen at menopause.

• Exposure to pollutants, toxins and endocrine-disrupting chemicals Such as herbicides and pesticides can cause a spike in the stress hormones which in turn affects the fertility hormones thereby leading to hormonal imbalance.

SIGNS AND SYMPTOMS OF HORMONAL IMBALANCE IN WOMEN       

It is possible to experience some or all of these signs and symptoms without knowing how it correlate with the hormones.

• Having irregular or missing periods.
• Excessive hair on the face, chin or other parts of the body.
• Male pattern hair growth or Hair loss.
• Vaginal dryness.
• Irritability and Moodiness.
• Infertility.
• Unexplained weight gain.
• Constipation and diarrhea
• Headaches.
• Vaginal Atrophy.

DIAGNOSIS OF HORMONAL IMBALANCES

To diagnose a hormonal imbalance an overview of the symptoms and a physical exam test may be needed. Various test such as:

•  Blood tests will be done to check for the levels of thyroid, estrogen testosterone and cortisol levels because most hormones are found in the blood.
• A pap smear will be done to check for unusual lumps, cysts or tumors. In male the physician checks the scrotum for any lumps or abnormalities.
• An ultrasound will be used to get images of the uterus, ovaries, testicles, thyroid and pituitary glands.
• An MRI or X-ray will be done to look for bone loss.
• A biopsy will be done if the tumor is suspected…TO BE CONTINUED