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Permanent Infertility With Long Term Use of Hormones

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Hormones play a significant role, and any changes in the hormone level cause many issues. Read the article to know more.

Written by

Dr. Dheeksha. R

Medically reviewed by

Dr. Raveendran S R

Published At May 12, 2023
Reviewed AtApril 1, 2024

Introduction

Hormonal imbalance occurs when there is too-much, too-little, or out-of-sync production of hormones. A proper hormonal balance is important for an efficient reproductive cycle like the ovulation process in women and the complete conception system. Hormonal imbalances are the major cause of infertility in women. It can also cause polycystic ovary syndrome (PCOS) and anovulation. Men also get affected by hormonal imbalances, such as low testosterone syndrome, which affects their infertility.

What Is the Hormonal Imbalance?

Humans use around 50 hormones to regulate different systems and body functions like growth, metabolism, and temperature regulation. Some hormones help to regulate the development and release of female reproductive cells or eggs. Hormonal imbalance occurs when there is a fluctuation in the hormone level in the bloodstream. Hormonal balance also depends on the following:

  • The hormone release time.

  • Interaction with other hormones.

  • Ability to respond through cell receptors.

An alteration in the hormonal level associated with the reproductive system in one or both partners, makes conception and pregnancy difficult. Hormonal imbalance is the major cause of infertility in women and men, which can be treated with lifestyle changes and medications.

How Do Hormones Affect Fertility?

Hormones play an important role in female reproductive health, controlling the menstrual cycle. For a pregnancy to occur,

  • Hormones in the body should signal and regulate the growth of an egg.

  • The release of the egg into the fallopian tube.

  • Thickening of the uterine wall for implantation.

  • The fertilized egg results in the embryo that moves to the uterus for implantation.

An absence or irregularity of one or more hormones can delay or prevent any of these processes from occurring, making pregnancy difficult.

What Are the Symptoms of Hormonal Imbalance?

Women experience one or more symptoms, such as

  • Absent or irregular menstrual cycle.

  • Spotting between menstrual cycles.

  • Heavy or painful menstrual cycle.

  • Increased hair growth on facial region, chest, neck, and back.

  • Increased weight gain.

  • Constipation and diarrhea.

Infertility in men due to hormonal imbalance is less, but some symptoms are:

What Are the Effects of Hormones on Fertility?

  • Follicular Stimulating Hormone (FSH):

FSH is an important hormone that helps with the menstrual cycle and deals with the maturation of eggs within the ovaries.

  • Luteinizing Hormone:

It regulates the release of matured eggs from the ovaries during ovulation.

  • Anti-mullerian Hormone (AMH):

These are produced by ovarian follicles that have immature eggs. This hormone helps to determine the number of eggs that remain in the ovary. Reduction in AMH may point to infertility.

  • Estrogen:

Estrogen is an important hormone that regulates the development of primary and secondary sexual characteristics and female reproductive health. The dominance of estrogen may sometimes lead to infertility.

  • Progesterone:

Progesterone is a hormone responsible for maintaining a pregnancy. It helps in uterine wall thickening, which helps in embryo growth. A low level of this hormone can result in miscarriage.

  • Thyroid Hormone:

Among the thyroid hormones, only T3 and T4 are associated with reproduction. They also affect digestion and the metabolic rate. If these hormones are imbalanced, then there may be difficulties with pregnancy.

  • Prolactin:

It is responsible for the secretion of breast milk, but it also plays a vital role in helping women get pregnant. If prolactin levels are imbalanced, that results in irregular periods and ovulation issues.

How Is Male Fertility Affected by Hormones?

Testosterone is a male hormone produced by the testicles, which contributes to overall well-being and sexual function and helps in sperm production. A low testosterone condition is called hypogonadism, which is lower than the normal range and varies widely. Some signs and symptoms of low testosterone cause issues with erections or decreased sex drive.

Low testosterone levels can be treated with medications through shots, gels, patches, or implantable pellets. Low-level testosterone does not lead to infertility, as other hormones stimulate sperm production. Testosterone is required for sperm production, but a very low or marginal level is enough for the production of sperm. But testosterone treatment results in infertility. It is caused due to reduction in other hormones like follicular stimulating hormone (FSH), which plays a significant role in sperm production. In most cases, infertility caused due to testosterone treatment is reversible. So any testosterone supplements result in hormonal imbalance and affect the production of sperm resulting in infertility.

What Are the Options for a Man to Have Children Under Testosterone Treatment?

The person should stop testosterone treatment until they have their biological children. Suppose a man is affected with a pituitary disorder that leads to low testosterone. In that case, he should be treated with pituitary hormones (hCG) that enhance testosterone without disturbing sperm production.

What Are the Causes of Hormonal Imbalance That Lead to Infertility in Women?

The most common causes of hormonal imbalance that results in infertility are

  • Anovulation:

This is a condition where a woman does not ovulate and has no chance of pregnancy.

  • Polycystic Ovarian Syndrome (PCOS):

PCOS is a hormonal disorder that causes the eggs to stay immature and forms cysts. This results in infertility and causes difficulty in getting pregnant.

  • Hyperprolactinemia:

This is a condition where a woman has excess prolactin in the body, resulting in an irregular menstrual cycle leading to infertility.

  • Estrogen:

    • If estrogen is high, it leads to fibroid formation or endometrial lesions that do not support embryo implantation.

    • It also disturbs the functions of the ovaries and fallopian tubes.

    • It leads to egg damage through an increased oxidative effect.

    • Low estrogen level in the follicular phase indicates improper growth of follicles.

    • An increase in the luteinizing hormone level is responsible for ovulation.

  • Progesterone:

    • When progesterone levels are low, it results in mid-cycle spotting and an irregular menstrual cycle.

    • If they are high, it results in

  1. Blotting.

  2. Brain fog.

  3. Tenderness and swelling of the breast.

  4. Constipation.

  5. Fatigue.

  6. Low mood or depression.

  7. Sleep disturbances.

  8. Easy to cry.

  • Thyroid Hormone:

Low thyroid hormone leads to an anovulatory cycle, disturbance in the ovulation process, and ovaries do not release eggs. It can also cause luteal phase issues that can result in early miscarriage.

  • Follicle Stimulating Hormone (FSH):

High level of FSH results in ovarian dysfunction.

  • Luteinizing Hormone (LH):

A low level of LH prevents ovulation, whereas a high level during the wrong time of the menstrual cycle can result in infertility as it plays a role in menstruation and ovulation.

How Is Hormonal Imbalance Resulting in Infertility Treated?

Depending on the hormonal imbalance causing infertility and the symptoms, medications are recommended to

  1. Regularize the menstrual cycle.

  2. Induce ovulation.

  3. Regulate the thyroid function.

  4. To normalize the prolactin level.

What Are the Causes of Hormonal Imbalance?

  • Stress.

  • Unhealthy diet.

  • Sleep cycle.

  • Diabetes.

  • Thyroid imbalance.

  • Long-term use of birth control pills.

  • Lack of exercise.

Conclusion

Hormones play an important role in the fertility of a person. It usually affects women more than men. Proper hormonal balance is crucial to maintaining a regular menstrual cycle and ovulation, which is very important for pregnancy. Each hormone plays a significant role in each process of pregnancy, so all the hormones should be maintained properly. Too much or too little hormonal level always ends up in problems.

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Dr. Raveendran S R
Dr. Raveendran S R

Sexology

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