Did you know that the hormones surging through your body influence or even control many of the most important bodily processes — including the ability to get pregnant? Because you can’t see or consciously adjust the levels of these critical compounds, it can be profoundly frustrating when you find yourself struggling to conceive if you suspect that a hormone irregularity may be at play.
Whether you’re just setting off on your family-building journey, or you’ve been trying for a while now, learning more about how your hormones impact fertility — and what you can do to minimize or eliminate issues — is a wise step.
We’ve asked fertility specialist Dr. Jennifer Mersereau to answer all your questions about hormonal imbalances.
1). Which hormones have an impact on fertility?
“While a few hormones seem to be named more often than others when it comes to conceiving, the truth is that many come into play,” shares Dr. Mersereau “In fact, the number of different hormones that impact fertility is one of the things that can make addressing hormone-related infertility particularly challenging. However, the good news is that if your periods are coming on a regular monthly basis, you are likely ovulating and your reproductive hormones are ‘in balance’. In cases where the period is very irregular, we can make the right adjustments to properly balance hormones, which will often lead to successful outcomes.”
Some of the hormones that will most significantly impact your ability to become pregnant are:
- Thyroid hormones – The thyroid produces many hormones, most notably triiodothyronine (T3) and thyroxine (T4) hormones. These hormones primarily impact metabolic rate and digestion, but they are also inextricably tied to reproduction. If you’re experiencing thyroid dysfunction, you may experience difficulties with ovulation or implantation.
- Prolactin – The hormone prolactin is critical to the production of breast milk, but it also plays an essential role in becoming pregnant in the first place. If your prolactin levels are abnormal, you will likely experience menstrual cycle irregularity, which in turn can cause issues with ovulation.
- Anti-Müllerian hormone (AMH) – This hormone is produced by ovarian follicles, or the small cycles that contains the immature egg. Its primary function is to support immature eggs. Measuring this hormone is one of the best predictors of how many eggs you have remaining in your ovaries.
- Follicle-stimulating hormone (FSH) – This hormone is directly linked to fertility, as its key function is to help regulate the menstrual cycle and induce the production of eggs in the ovaries. Women who have a loss of ovarian function often have higher FSH levels, as their bodies are trying to compensate for this dysfunction.
- Luteinizing hormone (LH) – This hormone signals the body to release a mature egg. Ovulation predictor kits depend on the measurement of this hormone, as levels generally surge immediately before ovulation.
- Progesterone – This hormone is essential to maintaining a pregnancy. Progesterone helps thicken the uterine lining, which in turn helps support an embryo.
2). What are common signs of a hormonal imbalance?
The most common signs of hormonal imbalance in women include:
- Menstrual cycle irregularity
- Spotting or irregular bleeding
- New or worsening acne
- Facial hair
- Male-pattern body hair
- Male-pattern hair loss
- Unexplained weight gain
- Extreme mood changes
3). What causes a hormonal imbalance?
The two most common causes of fertility-related hormonal imbalance are thyroid dysfunction and polycystic ovary syndrome (PCOS). Either condition can make getting and staying pregnant without medical intervention more difficult.
4). How can a hormonal imbalance impact my fertility?
With so many different hormones impacting your ability to conceive and maintain a pregnancy, it becomes easier to understand that a hormonal imbalance can cause an equal array of fertility challenges.
Two of the most common fertility issues linked to hormonal imbalance are:
- Ovulatory dysfunction – Hormone-related abnormalities, including irregularities in thyroid hormones and polycystic ovary syndrome (PCOS), can decrease the regularity of ovulation or prevent it altogether. When ovulation is interrupted, becoming pregnant is unlikely, as there is no egg to fertilize.
- Short luteal phase – The luteal phase immediately follows ovulation. The length of this phase is controlled by progesterone, the hormone that maintains the thickness and strength of the uterine lining. The average luteal phase is 13 to 14 days. “If you have a luteal phase shorter than 10 days, a fertilized embryo may not be able to implant, preventing pregnancy, and we recommend you come in for a simple fertility evaluation,” says Dr. Mersereau.
5). What information will a doctor need to help resolve hormonal imbalances and increase my likelihood of getting pregnant?
“The best thing you can do if you think you may have a hormonal imbalance, is to begin tracking your cycles and schedule a simple fertility evaluation with a specialist,” shares Dr. Mersereau “For tracking, you can do this either through the use of a traditional calendar or a specialized app. Information about the length of your cycles will help your doctor begin to confirm or rule out the presence of a hormone irregularity, as cycle irregularity is the most common sign of a hormonal imbalance.”
6). Are hormone levels impacted by age?
“Yes, definitely. As you age, many fertility-related hormone levels change substantially,” explains Dr. Mersereau. “FSH commonly increases as women start to have decreased ovarian function with age. AMH levels also change substantially, decreasing as you age as the number of eggs remaining in your ovaries decreases. Because fertility potential is impacted most by a woman’s age, we strongly encourage early intervention to increase your chances of pregnancy.”
7). Could it be that changes in my menstrual cycle are just the start of menopause?
Women in pre-menopause (known as perimenopause) often start to experience cycle changes in which their cycles change in length or, in some cases, stop altogether.
The best way to determine whether menopause is in play is to seek the help of a fertility specialist. Bloodwork results can determine your ovarian status and determine whether conception on your own is still possible.
8). Should I seek medical attention for a hormonal imbalance even if I’m not trying to get pregnant?
“Definitely, yes!” shares Dr. Mersereau. “Hormones impact much more than your reproductive system. Even if you’re not currently pursuing parenthood, if your menstrual cycles are very irregular, it’s important to see a doctor.”
9). How do you treat hormonal imbalances if I’m trying to get pregnant?
“There are various ways we can treat a hormonal imbalance and increase the likelihood of conceiving and maintaining a pregnancy,” shares Dr. Mersereau. “Treatments for hormonal imbalances are highly customized, as each hormonal imbalance is different.”
- Restore thyroid function
- Normalize prolactin levels
- Induce ovulation
- Trigger the release of a matured egg
Herbal remedies and similar ‘natural’ supplements are not regulated by the FDA; and therefore, their impact on a person’s body cannot be predicted — and may even be harmful. As such, our team does not encourage the use of these types of remedies.
“If your cycles are irregular that may mean your reproductive hormones are not in balance,” shares Dr. Mersereau. “Getting a firm grasp on a hormonal imbalance and its potential impact on fertility can be challenging. We remind our patients; they don’t have to exhaust their physical and emotional energies. We can provide the answers you need to truly take control of your fertility.”
Medical contribution by Jennifer E. Mersereau, M.D., MSCI
Jennifer E. Mersereau, M.D., MSCI, is board certified in obstetrics and gynecology (OB/GYN) as well as reproductive endocrinology and infertility (REI). Dr. Mersereau received her medical degree from the University of Pittsburgh School of Medicine. Following her passion for women’s healthcare, she then completed her residency in OB/GYN at the Feinberg School of Medicine at Northwestern University in Chicago, Illinois, where she also earned her Master of Science in Clinical Investigation. From there, Dr. Mersereau completed her REI fellowship at the University of California in San Francisco, California.
Editor’s Note: This article was originally published in January 2017 and has been updated for accuracy and comprehensiveness as of May 2023.