Can hormonal imbalance cause infertility?

Talking to your doctor is especially important when considering your fertility options. This article should not be considered medical or legal advice.

Did you know hormone imbalances are the No. 1 cause of infertility in women?¹ But how do you know if you have a hormone imbalance? And if you do, are you able to get pregnant naturally? 

The good news is, yes, there are many treatments available.  However, it's important to remember that research is still ongoing. While significant strides have been made in understanding hormones, new advancements are constantly being made.

What is a hormonal imbalance?

According to Cleveland Clinic, “a hormonal imbalance happens when you have too much or too little of one or more hormones.”¹ Hormones, often referred to as your body’s chemical messengers,² are really important. Produced in the endocrine glands, ovaries and testes, they affect sexual function, reproduction, growth and development, metabolism and mood.²

Hormones are powerful, even subtle imbalances can significantly influence cellular function and overall health.² But knowledge is power. Once your healthcare provider determines which hormones are out of balance, they can recommend next steps.

How can a hormonal imbalance cause infertility?

Several hormones can strongly impact fertility. A hormonal imbalance can cause infertility in various ways, depending on the hormone or hormones involved. For instance, hormones that cause irregular periods can make it harder to track ovulation and your fertility window.

Below we provide some general information on the more commonly known hormone imbalances that can affect fertility. To get a more in-depth understanding of how hormone imbalances affect fertility, or if you suspect a hormone imbalance is making it difficult for you to conceive, talk to your healthcare provider.

Estrogen imbalance and infertility

Estrogen: 

• Helps regulate the menstrual cycle³ 
• Promotes the development and release of eggs³ 
• Thins the cervical mucus to help sperm travel through the cervix into the uterus³
• Thickens the uterine lining to prepare for pregnancy.³

High or low levels of estrogen can disrupt the menstrual cycle.³ Additional estrogen-related conditions that can affect fertility include endometriosis, female sexual dysfunction (FSD), polycystic ovarian syndrome (PCOS), primary ovarian insufficiency (POI, also known as premature menopause), and uterine fibroids and polyps.³

Progesterone imbalance and infertility

Progesterone: 

• Prepares the lining of the uterus for a possible pregnancy each month.⁴
• If pregnancy doesn’t happen, progesterone levels fall and your uterine lining breaks down, leading to your period.
• If pregnancy occurs, progesterone supports the pregnancy.⁴

Low progesterone levels can lead to irregular periods and difficulty conceiving.⁴

Follicle-stimulating hormone (FSH) imbalance and infertility

FSH:

• Helps regulate the menstrual cycle, triggering the follicles in the ovary to grow and prepare eggs for ovulation.⁵
• FSH levels vary throughout the menstrual cycle, but continuously high levels of FSH could signal an issue with the ovaries, possibly POI⁵ or perimenopause.

Luteinizing hormone (LH) imbalance and infertility

LH:

• Regulates the function of ovaries
• Stimulates ovulation
• Increases progesterone (needed to help support a pregnancy)⁶

Elevated LH levels may indicate that your  ovaries are not producing enough estrogen and testosterone as needed. This can be due to a number of reasons from physiological causes to conditions like PCOS. Low levels may signify irregular or missed periods due to excessive exercise.⁶

Thyroid stimulating hormone (TSH) imbalance and infertility

TSH: 

• Stimulates your thyroid cells to generate two hormones, thyroxine (T4) and triiodothyronine (T3).⁷
• Rising or falling levels of T4 and T3 cause changes in the menstrual cycle, including heavy, irregular or absent periods.^7,8
• Additionally, an overactive or underactive thyroid can affect ovulation or prevent it from happening at all.⁸

Anti-mullerian hormone (AMH) imbalance and infertility

AMH relates to the number of eggs you have. As AMH levels fall naturally as you age, the number of eggs available for fertilization also falls.⁹ High levels of AMH can be a sign of PCOS.⁹

Prolactin imbalance and infertility

Prolactin promotes lactation.¹⁰ If you’ve recently lost interest in sex, high levels of prolactin could be to blame, as a rise in prolactin levels can cause vaginal dryness.¹⁰ High levels of prolactin can also lead to irregular or absent periods.¹⁰

What are some common symptoms of a hormonal imbalance?

A hormonal imbalance can cause many symptoms that vary depending on the hormone or hormones involved. If you’re experiencing any of the symptoms listed below, talk to your healthcare provider about whether a hormone imbalance may be the cause.

When should I see my doctor?

Because hormonal imbalance symptoms vary so widely and could indicate a range of conditions or issues, it’s important to talk to your healthcare provider anytime you notice a change in your body. If you feel you’re not getting the help you need, don’t be afraid to seek a second opinion! Symptoms for a hormonal imbalance are wide-ranging, so advocating for your health is key.

What does a hormone level test involve?

Your healthcare provider will determine what types of tests are necessary based on your symptoms, health history and more. A blood test is the most common way to determine hormone levels.¹¹ The kind of tests used will depend on your use of hormonal birth control. Imaging can take a closer look at the pituitary gland, uterus, ovaries and thyroid, if needed.¹¹

How can I balance my hormones?

Depending on your test results, your healthcare provider will likely offer ways to help get your hormones back in balance. Some people take nutritional supplements, but there is little scientific evidence pointing to their efficacy.¹ However, your healthcare provider may recommend lifestyle changes such as managing stress and exercising regularly.¹ They may prescribe medication (including hormonal birth control), suggest hormone replacement therapy or radiation therapy, or recommend surgery depending on your personal circumstances.¹

Bottom line? Talk to a healthcare professional if:

• You’re under 35 years old and you’ve been trying to conceive (TTC) for more than a year with no luck.
• You’re over 35 years old and you’ve been TTC for six months.
• You’re over 40 years old and TTC.
• You’ve been trying to get pregnant, but something just feels off.

Hormones are small but mighty, and an imbalance can cause issues with fertility and your general health. Your healthcare provider can pinpoint whether there is an imbalance and recommend solutions that fit your needs.

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