Hormonal disorders in women

Hormones play a key role in our bodies. They regulate many biological processes, including large parts of the male and female reproductive systems. Hormonal disorders, therefore, could be (part of) the reason why you haven’t managed to get pregnant so far. If there is a possibility that you’re experiencing this issue, we determine whether it really does play a part in your infertility by executing several hormonal analyses in our laboratory. These will provide clarity regarding your hormonal situation as well as treatment options in our clinic.

The hormonal systems in your body are quite complex, which means that the smallest hormonal deviations can disturb the balance. Often, hormonal imbalance is caused by the dysfunction of one of the hormone-producing organs, such as the pituitary gland, hypothalamus or thyroid. A disturbance in the production of hormones can influence female fertility:

• through the interruption of oocyte maturation
• through failure to ovulate
• through a lower production of progesterone

Hormonal imbalance can also be caused by such issues as being severely over- or underweight, extreme fluctuations in weight, stress, medications or (very rarely) tumors. 

A normal menstrual cycle does not take less than 21 or more than 35 days. During a regular menstrual cycle, ovulation will generally occur. If your cycle is irregular or your period failed to happen, though, ovulation may not take place. This can have a negative influence on your odds of conceiving. Hormonal imbalance can cause disruptions or irregularities in your menstrual cycle.

If you’re trying to conceive, it’s important to have a regular menstrual cycle. If ovulation doesn’t happen regularly, you’ll usually experience fewer ovulations a year, which decreases your odds of conceiving. In addition to this, irregular menstrual cycles make it more difficult to determine when ovulation (and, consequently, your fertile period) will take place. This, too may make it harder to conceive.

If someone is suffering from polycystic ovarian syndrome (PCOS), the ovaries do not work as they should, due to several hormonal disruptions influencing and amplifying each other. An identifying feature associated with PCOS is raised blood levels of male reproductive hormones (such as testosterone). Due to elevated production of FSH and LH, several follicles will start to mature in the ovaries. But the raised testosterone levels prevent these follicles from maturing completely, resulting in ovulation happing either not at all or very rarely. On an ultrasound, these follicles show up as small black ovarian cysts. PCOS will almost always lead to irregular or nonexistent menstruation, also known as amenorrhea. If PCOS is the reason behind not being able to conceive, you have several treatment options using medication.  

Many hormonal disorders will take place at the same time, influencing each other. For example, hypothyroidism is often seen in combination with raised prolactin levels, and PCOS often goes together with raised androgen levels. Our specialists will provide extensive information regarding causes and symptoms for all disorders listed below if you come in for a hormone analysis.

• A GnRH disorder / dysfunctional pituitary gland: the pituitary gland regulates the production of the female sex hormones FSH and LH. If there is a problem with the functioning of the pituitary gland or the production of the transmitter GnRH, consequences to oocyte maturation may occur.
• Raised prolactin levels: the hormone prolactin is usually emitted during lactation. It slows FSH and LH production, so ovulation will not occur as often as usual. In non-lactating women, excessive prolactin production can be traced back to a disorder in the pituitary gland. It may cause lactation without having been pregnant.
• Hypothyroidism: if the thyroid produces too little iodine-containing hormones, the hypothalamus will emit higher amounts of TRH, a hormone that stimulates the thyroid. It also stimulates the production of prolactin, so ultimately it can cause a failure to ovulate due to raised prolactin levels.
• Decreased functioning of the corpus luteum: if the corpus luteum, which develops after ovulation, produces too little progesterone hormone, that’ll influence whether an oocyte manages to lodge in the womb or not.
• POF (premature ovarian failure): For 1% of women, menopause starts before they reach 40. The age when someone starts to experience menopause is partially genetically determined. Your mother’s age when she started menopause is a decent indicator of when you will start. If the ovaries do not contain any more oocytes and menstruation stops due to that, it’s considered menopause.

In menopausal women, FSH levels are raised. It’s considered premature menopause when four consecutive periods fail to occur in a woman less than 40 years of age, and, during this time, FSH hormone concentration is measured to be over 40 IU/I (normal range: up to 10 IU/I). However, it’s possible to start menstruating again for a few months, or to alternate periods with and without menstruation. Using ultrasound examinations and blood tests, we can determine whether yours is a case of premature menopause, also known as POF. These examinations can also provide information on the number of oocytes left in the ovaries.

In general, hormonal disorders can be identified through targeted blood testing. However, please keep in mind that there are many possible causes for being unable to conceive, and several of them may be playing a role at the same time. Our physicians will tailor their examinations and treatment options to your unique situation to maximize your chances of a successful pregnancy.