Fertility
Why do Hormones Influence Fertility?
Eloise Edington | 19 Oct 2021
Have you been TTC for a while? Struggling to get pregnant? Worried there might be something the matter?
You may need to take a closer look at your hormones as they are inextricably linked to fertility health.
For our Fertility Help Hub readers, Your Hormone Balance explains how understanding your unique hormone balance, and maintaining it with food and fertility supplements, can help to achieve pregnancy.
Infertility is one of the top symptoms reported among women of reproductive age in our practice, yet it’s an issue that’s closely tied to hormone imbalance, and in many cases, can be improved with natural rebalancing techniques.
Current stats from the CDC find that approximately 22.3% of married women have problems achieving pregnancy or carrying to term. In Dr. Aviva Romm’s new book, Hormone Intelligence, she points out that over 40% of infertility causes are attributable to women and many are due to “unknown reasons” (i.e. hidden causes that conventional medicine doesn’t recognize or address).
If you’re reading this fertility blog because you’re struggling to get pregnant, we know that it can be an emotional rollercoaster, filled with highs and lows and moments of frustration and upset with your own body. But know that you are not alone and the word “infertility” is not final! When it comes to getting pregnant and bringing a healthy baby into the world, it starts with understanding your unique hormones and nourishing them with fertility boosting foods, self-care, movement and specific supportive fertility supplements.
Understanding the hormone connection to infertility
Infertility has many root causes and contributing factors, but here’s an overview of the top four:
Ovarian insufficiency: This condition (also known as premature ovarian failure) occurs when the ovaries stop functioning normally and releasing eggs regularly before age 40. In other words, sometimes the ovaries switch on and start producing estrogen and sometimes they don’t. Declining ovarian function is the main catalyst for age-related decline in female fertility but it’s not the same thing as premature menopause (12+ months without a period). Women with ovarian insufficiency can have irregular periods and even get pregnant (while women with premature menopause cannot).
Causes of ovarian insufficiency are not always known but can be due to autoimmune issues, toxins (cigarette smoke, chemicals, pesticides, chemotherapy, radiation) chronic stress or genetic defects.
Luteal Phase deficiency: In some women who struggle with infertility, ovulation may occur normally but levels of progesterone are too low following ovulation (i.e. the luteal phase). This means that even if an egg is fertilized, implantation either does not occur or, if it does, progesterone levels are not high enough to maintain the pregnancy into the first trimester.
The most common root cause of luteal phase deficiency is inadequate progesterone production by the corpus luteum (formed from the ruptured follicle upon ovulation, every cycle), chronic stress with cortisol ups and downs that disrupt ovulation, and imbalances of the thyroid that can also play a role. This is why focusing on balancing estrogen and progesterone levels, as well as strengthening the adrenal glands (which produce cortisol), is key.
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting more than 5 million women in the US alone. It is one of the leading causes of infertility and (other than the default prescriptions for contraceptives or Metformin) conventional medicine often considers it “untreatable”. Despite this, a growing number of experts in the functional medicine space strongly disagree, citing numerous cases of PCOS shown to be 100% reversible through diet and lifestyle interventions, including specific herbs and supplements. Therefore, it is important to become your own health advocate and question any doctor who suggests synthetic birth control or medications (which disrupt your natural balance of hormones causing weight gain, acne, mood swings and challenges getting pregnant) as the only answer, when there are more natural, safer solutions.
High androgens (Testosterone & DHEA) and insulin resistance: This resistance is almost always at the root of PCOS – which is also closely associated with metabolic syndrome and future risks for developing diabetes and cardiovascular disease.
Top symptoms of PCOS include: irregular/absent periods, acne/oily skin, weight gain/weight loss resistance, excess facial/body hair, sugar/carb cravings, fatigue, deepening of the voice, thinning hair on the top of the head. For women with PCOS or those who have intense sugar/carb cravings daily, it’s important to test androgen hormone levels and look into insulin and blood sugar imbalances which also play a significant role.
Natural approaches to improve fertility
STEP 1: Test ‘ACTIVE’ hormone levels to detect potential imbalances related to infertility
If you’ve been suffering from persistent symptoms or chronic health issues, including difficulties getting pregnant or miscarriage, testing your hormone levels is an important first step that can help identify root causes and next steps.
NOTE: the type of testing matters (as well as the specific hormones measured), especially when it comes to fertility challenges.
TEST YOUR “MASTER HORMONES” UPFRONT
At Your Hormone Balance, we prefer testing the “master hormones” in saliva (estrogen, progesterone, “PG/E2 ratio”, testosterone, DHEA and cortisol levels – 4 x over the course of 1 day), considered by many experts to be the “gold standard” for assessing adrenal function and a more accurate measure of “bioavailable” or ACTIVE hormone levels – found in the target tissue of the body where hormones do their work! Meanwhile, standard blood tests (unfortunately the main type provided by traditional doctors and covered by insurance) measure TOTAL hormones, including those still bound to proteins in the bloodstream, which are inactive and tell us very little about symptoms that are actively being experienced!
This is why SO many women come to us after receiving blood test results, being told everything looks “normal” even though they feel anything but normal. (You can read more about the top reasons we prefer saliva to blood testing here. Note: urine testing is also a more reliable form of testing compared to standard blood tests.)
At Your Hormone Balance, we pair comprehensive saliva test results with an in-depth hormone rebalancing guide, including an individualized “snapshot” that breaks down your key hormone levels and explains which of your moderate and severe symptoms connect specifically to imbalances detected through testing. We then provide insights related to each imbalance and associated symptoms – including specific diet, lifestyle and stress management suggestions, as well as a guide to the top fertility supplements, herbs and plant-based hormones (if testing indicates a need) known to support imbalances as well as support your overall hormone health.
Testing these specific “master hormone” levels is important for many of the reasons already discussed, but to recap:
- Knowing where your estrogen levels lie – relative to progesterone (determined by the “pg/e2” ratio) is helpful for assessing whether or not you have adequate amounts of progesterone to balance estrogen, necessary for regular ovulation, conceiving and maintaining a pregnancy
- Measuring your active or “free” androgen hormone levels (DHEA and Testosterone) is important for evaluating risks for PCOS – a leading cause of infertility
- Measuring cortisol levels 4 times over the course of one day (morning, noon, evening and night) provides a wealth of information related to your sleep, energy, moods and stress. Cortisol levels that are above or below the optimal range can be taken as an indication of chronic or persistent stress – known to impact ovulation and contribute to Luteal Phase Deficiency
If interested in testing these hormones and receiving an all-natural rebalancing guide – check out our and use code “FERTILITYHELPHUB” for $25 off testing + rebalancing packages.
NOTE: saliva must be collected on a specific day of your cycle (generally Day 19, 20 or 21 for 28-30 day cycles; we provide details for other cycle lengths). Those with irregular or absent cycles can test any day of the month.
TESTING FERTILITY MARKERS
Interested in testing your fertility hormones from home? We’re fans of Modern Fertility‘s at-home finger prick test which is customized to your method of birth control and is the same hormone test offered by Reproductive Endocrinologists for a fraction of the price. They test up to seven hormones and deliver the results via comprehensive reports and dashboards. You also get a call with a fertility nurse to chat through your results and have your fertility concerns addressed.
NOTE: the blood test is typically collected on Day 3 of your period and the information and education provided is fertility specific and does not overlap with the education + test markers in our ‘saliva master hormone’ profile.
The more education and information you can get about your unique hormone levels and health the better. When we aren’t getting the answers or support we need, we have to become our own health advocates by testing and charting our symptoms and making intentional lifestyle, diet and stress management changes to rebalance and find relief.
STEP 2: Incorporate specific lifestyle and nutrition changes to support fertility
Here are some of our favorite lifestyle habits to incorporate for those preparing for a healthy pregnancy:
TRACK YOUR CYCLE
One of our primary suggestions for women of reproductive age who want to get pregnant is to track their cycle regularly, using either the calendar method, BBT tracking or hormone testing. Understanding where you are in each of the four phases of your cycle, what symptoms correlate to the different phases, and when you are ovulating are the best ways to get in tune with your body and understand your fertile window so you can plan a family with the right tools.
We love the MyFLO Period App by Flo-Living which analyzes all information you input (i.e. mood and symptoms) and helps you eliminate unwanted symptoms and schedule your life according to your personal cycle and pregnancy goals (nutrition, movement, self-care).
Note: If you are still using hormonal birth control but hoping to get pregnant in the next 1-2 years, we highly encourage transitioning to a non-hormonal birth control or use tracking apps as soon as possible, to allow enough time to rebalance the effects post hormonal birth control.
Natural Cycles is the first FDA cleared, non-hormonal birth control app and it’s 98% effective with perfect use and 93% effective with typical use. It works by identifying your fertility from your basal body temperature which you track by taking your temperature first thing in the morning (using the thermometer included within the subscription). Simply enter the reading into the app, and after it gathers enough data (from consistent use), it will tell you if you are fertile (RED), or if you are not fertile that day (GREEN). You can also customize the app whether you are planning or preventing pregnancy, and you can even “Follow a Pregnancy” to track stages of foetal development if you are pregnant. You will also receive personalized messages and reminders correlating to your specific needs and goals.
Eat foods that help your fertility
Nutrition can fuel your fertility and is one of the most powerful tools in your fertility toolkit! Here are some of the top superfoods to add into your daily and weekly rotation:
Avocados – (1 per day) contain the best kind of monounsaturated fat and the least saturated fat, making them the ideal food for boosting the health and viability of your eggs.
Royal Jelly – produced by honeybees, Royal Jelly is super nutrient-dense with a complex blend of proteins, vitamins, calcium, fatty acids, amino acids, iron, sugars, and enzymes that can support fertility. There have been multiple studies on fertility in animals that suggest it has the potential to increase rates of pregnancy. Learn more via our IG post here.
Turmeric – improves circulation to all organs – including the uterus and ovaries and is extremely anti-inflammatory so it’s a great herb to add year-round. Enjoy thrown into smoothies, soups/curries, baked goods and golden milk lattes.
Leafy greens – magnesium is a vital nutrient for optimizing fertility and dark, leafy greens like spinach and chard have the highest level of magnesium of any foods (also rich in cacao, avocado, nuts, seeds).
Pasture-raised, organic eggs – enjoy them poached or soft boiled to preserve the vitamin D and B6 content, which supports progesterone production! This brand is wonderful.
Fiber – is essential for everyone’s diet (at least 25-35 grams per day, but increasing your intake while trying to conceive may significantly improve your chances). It can help your body remove excess hormones like estrogen while keeping your blood sugar levels in control.
Vitamin B6 rich foods – (like sweet potatoes, pork, poultry, oats and banana) have been shown to improve progesterone levels and Vitamin B6 is one of the vitamins women who are trying to conceive often take. Research has shown that women who have higher levels of vitamin B6 in their blood have reduced miscarriage rates by 50%!
Stay hydrated – In addition to improving blood flow, proper hydration ensures your cervix is easily penetrated by sperm as it adds viscosity to your cervical mucus. On the flip-side, dehydration is detrimental to egg health, making it less likely one will become fertilized or develop into an embryo. Have trouble getting in enough water? Add delicious electrolytes like Ultima Replenisher to your water (especially on hot days or after workouts).
Reduce caffeine. Women who drink a lot of coffee have fewer chances of conceiving and caffeine has been shown to increase the chances of miscarriage when consumed in excess. If you’re a coffee-lover, you don’t have to avoid coffee completely, but simply try to be moderate with your caffeine consumption and consider low to no caffeine alternatives like our health coach Jess’s Detox & Energy latte blends (including a zero sugar, decaf Pumpkin Spice Latte blend.
Maca – this Peruvian plant and adrenal adaptogen has been shown positively to affect sperm levels. We love the Mary Ruth Organics tincture.
Focus on cortisol balancing to manage your stress
Chronic or persistent stress (cortisol imbalance) is a catalyst for trouble getting pregnant, mainly because stress can interfere with natural hormone rhythms and suppress ovulation. Here are some important self-care strategies to consider:
Deep breathing: Adopting a daily breathing practice can make a major difference and it’s free! One of the simplest techniques we love is the 4-7-8 breath by Dr. Andrew Weil. Exhale all the air from your lungs, then breathe in for a count of four, hold your breath for a count of seven, and exhale for a count of eight. This is a great technique to add in before bed or if you wake up in the middle of the night and struggle to fall back to sleep. Set little reminders on sticky notes in the places you frequent most (bathroom mirror, fridge, office desk etc) until the practice becomes a habit.
Slow down when you eat: Most of us can be found scarfing down a meal. This rushed approach to everyday living keeps our body in a “fight or flight” state which can create digestive issues, cravings and hormone imbalances. Give yourself 15-20 minutes to enjoy a meal away from distractions and observe the difference in how you feel physically and mentally.
Trade over-exercising for restorative movement: It’s normal to feel the pressure to work out harder in order to see results but this overtraining can raise Testosterone to high levels that contribute to PCOS and can be a stressor on the body that taxes your adrenal glands. Swapping intense exercise for a couple days of restorative yoga, pilates or walking each week will bring down those cortisol levels and recharge your body and mind. Yoga with Adriene on YouTube is a great place to start!
Nap when you feel tired: In our on-the-go society, it’s normal to think of a nap as a waste of time or that it will mess up our sleep schedule, but laying down for a quick nap (under 30 min) can give us the boost we need to power through the day while supporting our adrenals!
Take responsibilities off your plate and learn to set boundaries: As challenging as this is since many of us have been programmed to be “yes people,” we have to stop expecting ourselves to be superheroes and take some pressures off our plate for the sake of our health and wellbeing. If you don’t have the interest or capacity for something, it’s ok to say no!
Sunlight and Vitamin D: Sunlight is essential for healthy fertility (and stress reduction), but with autumn in full force and winter approaching, we are facing darker days with long nights and cloudy weather. A natural vitamin D3 boost maximizes your ability to conceive, so taking sunshine breaks (when weather permits) is medicine. When daily sun exposure isn’t a frequent option, consider supplementation.
Studies have revealed that 93% of women dealing with infertility issues are vitamin D3 deficient.
STEP 3: Supportive fertility supplements (prenatals)
Finally, there are many helpful fertility vitamins and herbs for fertility support. Taking a high quality prenatal specifically designed to provide everything a growing foetus needs is really important, however not all supplements are created equal so we suggest reading ingredients closely.
To understand what other herbs and supplements will be best for your unique body and fertility, we always encourage testing your hormones to know where your specific levels lie, so that you can determine which interventions (fertility diet, lifestyle, supplements) will be most helpful based on your current levels!
Feel free to reach out to YHB at info@yourhormonebalance.com with any questions. If interested in testing any of the mentioned hormones and receiving an all-natural rebalancing guide – check out YHB testing + rebalancing packages (and use code “FERTILITYHELPHUB” for $25 off any package).
