Previously, we discussed the causes of hormonal imbalance, symptoms, testing and types of hormones.

In part two, we will look at the key hormones that are linked to fertility health in both women and men.

In women

Oestradiol (E2 oestrogen):

Oestradiol is mainly produced by the follicles and corpus luteum (remnant egg sac) in the ovaries.

This oestrogen is the most potent and abundant.

Oestrogen is needed for healthy bone formation, gene expression, maintaining healthy cholesterol levels, and formation of secondary sexual characteristics (pubic hair, breasts, etc).

Oestradiol is commonly found in other animals like crustaceans, insects and fish.

Progesterone:

This hormone is important for a healthy libido, bone formation and proper blood clotting.

As one of the main hormones in helping to regulate the menstrual cycle, progesterone works to balance the effects of oestrogen.

It also plays a role in your susceptibility to diabetes or insulin resistance, as it signals the release of insulin.

Progesterone is vital for conceiving and maintaining pregnancy, and adequate levels of progesterone are essential for proper Fallopian tube function.

One of the main actions of progesterone is to help support a developing embryo. During pregnancy, the placenta produces progesterone to help sustain the developing baby.

Luteinising Hormone (LH):

This hormone is produced in the anterior pituitary gland, helping to regulate ovulation and your menstrual cycle. It works alongside follicle-stimulating hormones (FSHs), rising and falling together during the monthly cycle.

For men, it stimulates specific cells to produce testosterone.

You can take a luteinising test if you are unable to get pregnant to help you examine irregular periods and any problems associated with development of sexual organs.

Cortisol:

This is produced by the adrenal glands, but it is controlled by the hypothalamus.

Its primary function is to increase blood sugar; aid in fat, protein and carbohydrate metabolism; and suppress the immune system.

Cortisol is released in response to stress.

DHEA (dehydroepiandrosterone):

DHEA is the key building block for producing testosterone and oestrogen.

It is necessary for building and repairing protein, and comes from the adrenal glands. DHEA levels decline dramatically as we age.

Testosterone: This hormone is associated with men, but women produce it as well, albeit in much lower amounts than men. It helps to support a healthy sex drive and build bones.

In men

Testosterone:

Men produce and secrete this hormone mainly via the testicles, but the adrenal glands also contribute to producing testosterone.

This hormone is vital for the development of the testes, prostate and secondary sexual characteristics. Males reaching puberty see an increase in muscle mass, bone mass and the growth of body hair.

It is also responsible for libido, erection and reproductive function.

Oestrogen:

Men produce much lower levels of oestrogen, but without oestrogen, sexual arousal could not happen.

Oestrogen is responsible for many functions in the health of the body, in both men and women.

Without appropriate levels in men, sexual function will be decreased.

Too much oestrogen may cause erectile dysfunction, low/lack of libido, low sperm count, and lowered production of seminal fluid.

Progesterone:

It regulates certain body systems just as it does in women, minus the reproductive functions.

Progesterone is considered to be an anti-inflammatory agent.

Its other actions include normalising blood clots and vascular tone, and aiding in the regulation of the mineral levels of zinc and copper in the body.

Additionally, it helps to regulate cellular oxygen levels and the use of fat stores for energy production.

LH:

Acting on Leydig cells within the testes, LH is responsible for the production of testosterone and plays a role in the creation of sperm.

FSH:

This hormone plays a vital role in signalling spermatogenesis. This is the very beginning of the creation of sperm.

DHEA:

Helps men maintain testosterone levels, which is important for sex drive and sustaining an erection.

Cortisol:

Increases blood sugar; aids in fat, protein and carbohydrate metabolism; and suppresses the immune system. Cortisol is released in response to stress.

Signs and symptoms of hormonal imbalance

Symptoms of hormonal imbalance can be inconvenient, but might also be a blessing, as your body is sending a signal that something needs to be changed.

In women, these could include breast tenderness, pre-menstrual tension (PMS), insomnia, unexplained weight gain, headache, migraine, anxiety, depression, vaginal dryness, lethargy, hot flashes, cold hands and feet, mood swings, thinning hair (facial or body), thin or dry skin, acne, intolerance to hot or cold, sluggish metabolism, fat gain around stomach area, allergy symptoms, hives, asthma, decreased sex drive, irregular periods, infertility, increased blood clotting, recurrent miscarriage, not ovulating, breast swelling, water retention, incontinence, heart palpitations, obesity, bloating, rapid heartbeat, poor egg health, premature ovarian failure, fluid discharge from breasts, cravings for carbs, sugar and salt, and frequent illness.

Getting a hormone test

If you have been struggling to get pregnant or keep a pregnancy, and you have nodded yes to more than two of the symptoms above, it is important you get your hormone levels tested.

But the responsibility should not fall on women alone. Bring your spouse along for testing as well to get a full picture of your fertility health.

I suggest that you get the following hormone levels tested:

For women: progesterone, oestradiol, FSH, LH, prolactin, testosterone, sex hormone binding globulin, thyroid panel and blood lipid profile.

For men: testosterone, DHEA, oestradiol, progesterone, FSH, LH, prolactin, cortisol and glucose tolerance test.

Once the test results conclusively show that your hormone levels are not where they should be, you will be able to do something about it.

There are natural therapies that can help to restore hormonal balance.

A nutrient-dense diet, daily exercise, stress management techniques and avoiding harmful substances are the foundation for maintaining and restoring hormonal balance.

Supplements such as omega 3, vitamin E and minerals like zinc support optimum nutritional balance, which in turn may restore your fertility health.

If you still have questions about the topic, a discussion with your doctor will lead to the best options for restoring hormonal balance, whether by adjusting your lifestyle and food intake, or through safe medical means.


Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist. For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.