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How Hormonal Imbalance Can Impact Fertility (And What You Can Do About It)

How Hormonal Imbalance Can Impact Fertility (And What You Can Do About It)

Key Hormones That Affect Fertility

Your body has many different hormones, many of which come directly into play when you’re trying to conceive. Hormonal imbalance with any of the following hormones could make it difficult to get pregnant.1

Endocrine disorders and fertility and pregnancy: An update. Front Endocrinol (Lausanne). 2023.

Follicle-stimulating hormone (FSH)

FSH is one of the most important hormones for fertility. This hormone is made in the pituitary gland and is responsible for maintaining menstrual cycle regularity and producing healthy mature eggs. It also controls sperm production in people with testes.

An imbalance in FSH can lead to fertility, menstrual, and libido problems.

Luteinizing hormone (LH)

LH, or luteinizing hormone, may sound familiar; it’s the hormone that’s measured in at-home ovulation predictor kits (OPKs). Like FSH, the pituitary gland makes this hormone. LH is the hormone that tells your body to release an egg that’s ready to be fertilized. It also causes the testes to produce testosterone, which is needed for sperm production.

An imbalance in LH can lead to infertility, irregular menstruation, and low libido.


The hormone progesterone is critical in preparing the body for pregnancy and helping a new pregnancy thrive. Specifically, it triggers the uterine lining (endometrium) to thicken to prepare for a fertilized egg. It also keeps the uterine muscles from contracting so the egg is not rejected. This hormone is produced in the ovaries after ovulation.

Plummeting progesterone levels are often a culprit in repeated miscarriages.


If you think that this hormone is the one that handles milk production, you’d be correct! But it’s also a key player in ensuring your menstrual cycle stays regular, which is important when trying to conceive. This hormone is made in the pituitary gland.

An imbalance in prolactin, especially excess prolactin, can cause menstrual and fertility problems, low sex drive, and erectile dysfunction.

Causes of Hormonal Imbalance

If you have a hormonal imbalance, it’s normal to feel that you’re to blame. However, it’s important to know that it’s not your fault and you’re not doing anything wrong.

“For better or worse, there are very few things we can do lifestyle-wise that negatively (or positively) impact hormone production and balance,” says Emily Jungheim, MD, chief of reproductive endocrinology and infertility in the department of obstetrics and gynecology at Northwestern University.

Causes of hormonal imbalance can include:

  • Age
  • Certain medications
  • Exposure to certain chemicals
  • Food allergies
  • Low body fat
  • Obesity
  • Polycystic ovary syndrome (PCOS)
  • Stress
  • Thyroid disease
  • Excess exercise
  • Eating disorders

Dr. Jungheim says weight-related issues, like obesity and low body fat, can lead to hormonal imbalances. These changes can impact both your menstrual cycle and ovulation.

Symptoms of Hormonal Imbalance

If you’ve been trying to conceive for more than a few months and you’re otherwise healthy, it may be time to consider your hormone levels. Symptoms of hormonal imbalance vary, depending on which hormones are involved.

Symptoms of reproductive hormone imbalance

According to the Endocrine Society, some symptoms that may indicate a reproductive hormone imbalance include:6

  • Abnormal uterine bleeding
  • Acne
  • Appetite changes
  • Depression or anxiety
  • Early menopause
  • Excess body and facial hair
  • Fatigue
  • Fibrocystic breasts
  • Hot flashes
  • Infertility
  • Insomnia
  • Low libido
  • Menstrual cycles that are irregular, excessive, or absent
  • Mood swings
  • Premenstrual syndrome (PMS)
  • Recurrent miscarriages
  • Uterine fibroids
  • Vaginal dryness
  • Weakness
  • Weight changes

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Symptoms of thyroid hormone imbalance

According to the Office on Women’s Health, symptoms associated with thyroid hormone imbalance include:7

  • Appetite changes
  • Constipation or diarrhea
  • Depression, anxiety, and irritability
  • Dry, thinning hair
  • Eye changes (puffiness, bulging, redness)
  • Fatigue or trouble sleeping
  • Feeling cold or hot when others are not
  • Hoarse voice
  • Joint or muscle pain
  • Menstrual changes
  • Muscle weakness
  • Pale, dry skin
  • Puffy face
  • Slow or rapid heart rate
  • Sweating more or less than usual
  • Trembling
  • Weight changes

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When To Test for Hormonal Imbalance

Fertility isn’t one-size-fits-all, and there are many factors that influence a person’s ability to conceive. Each person is different, making it tough to determine exactly when it’s time to take action. However, in general, Dr. Jungheim suggests getting your hormones checked in the following cases:

  • You haven’t conceived after six to 12 months of trying (six months if you’re over 35)
  • Your cycles are irregular and unpredictable
  • You have symptoms of PCOS or a thyroid condition

Another scenario where hormone testing makes sense? If you’re planning to have your eggs frozen for later use. “An AMH level can be helpful in understanding how many oocytes one might expect to get during a banking cycle or during IVF,” says Dr. Jungheim.

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Treating Hormonal Imbalance to Get Pregnant

How hormonal imbalance is treated will depend on the underlying cause of the imbalance.

PCOS is one of the most common causes of hormonal imbalance that interferes with getting pregnant. According to the Office on Women’s Health, treatment to increase fertility with PCOS includes:8

  • Weight loss to regulate your menstrual cycles
  • Medication to help you ovulate, like Clomid (clomiphene)
  • In vitro fertilization (IVF)
  • Surgery to restore ovulation

If your hormonal imbalance is due to thyroid disease, on the other hand, the most likely course of action is thyroid medication to correct the problem. Which type of medication will be best for you will depend on whether you have an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism).

With hyperthyroidism, an antithyroid drug helps the thyroid make less thyroid hormone. For hypothyroidism, hormone therapy helps supply the body with sufficient thyroid hormone.

Key Takeaways

Having a hormonal imbalance can impact fertility in a variety of ways. A number of hormonal imbalance tests (including at-home options) can let you know if your hormone levels may be contributing to fertility issues. Getting a proper diagnosis and treatment plan can improve your odds of conception.

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