Download The ovaries produce oestrogen and progesterone and 1 egg each

Menstrual Hormones & Fertility
BLOOD TEST & HORMONES
FSH < 6mlU/ml excellent; 6-8 good; 9-10 fair; 11-13 poor reserve. High levels = poss PCOS, menopause.
Oestradiol 25-75pg/ml
LH < 7mlU/ml
Prolactin < 24ng/ml
Progesterone >15ng/ml
Thyroid (TSH) 1.7ulU/ml
Testosterone 6-86ng/dl: >50 elevated.
Luteinizing Hormone (LH):
Released by the pituitary, stimulates ovulation,
the formation of the corpus luteum and the
production of progesterone by the ovaries.
Tested days 1-3, high levels may indicate PCOS
or menopause.
Prolactin:
Secreted by the pituitary, controls milk
production and stimulates progesterone. Tends to
be higher in the LH phase. It is tested if PCOS
is suspected. High levels may cause ovulation
problems or low progesterone which may cause
difficulty maintaining pregnancy.
Thyroid (TSH):
Produced by the pituitary, controls thyroid
function, important for metabolic processes and
body systems. A high TSH level + low thyroxine
(T4) level usually points to under active thyroid,
a factor in infertility. If TSH levels are normal +
low T4, there is a poss pituitary problem.
Androgens (Testosterone):
Level checked at beginning of cycle to eliminate
possibility of PCOS. If the pituitary produces
high levels of LH, it prevents ovulation and
causes the ovaries to secrete high levels of male
hormone.
Progesterone:
Checked at day 21 (7-10 days after ovulation in
a 28 day cycle, or 7 days pre-period), when the
follicle releases it’s egg, it becomes the corpus
leuteum and progesterone is produced. It
indicates if ovulation has occurred, or if there is
Luteal phase defect (LPD) which may cause
pregnancy difficulty.
The ovaries produce oestrogen and progesterone and 1 egg each month.
There are two phases:
(i)
(ii)
Follicular phase associated with oestrogen production stimulates development on the egg
until release (Ovulation).
Luteal Phase associated with progesterone stimulates endometrium (womb lining) growth
to sustain a fertilised egg.
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Menstrual Hormones & Fertility
FOLLICULAR PHASE:
Begins the 1st day of menstrual bleeding. The egg (ovum) begins development. It contains half the genetic
material required, the other half is provided by the sperm, for the foetus.
At the start of the follicular phase, the hypothalamus (regulates the Pituitary gland) in the brain releases
gonadotrophin –releasing hormone (GnRH), this stimulates the pituitary to release follicle-stimulating
hormone (FSH), which stimulates the eggs to develop in the ovary.
Up to 20 eggs may respond and
develop within sacs called follicles,
which provide nourishment for growth.
As the eggs develop, the ovaries release
oestrogen. This causes the pituitary to
reduce FSH so that only sufficient is
available to stimulate growth of 1 egg,
the others deteriorate. Oestrogen also
stimulates the uterus lining
(endometrium) to thicken for fertilised
egg implantation. The primary follicle
contains the developing egg.
The oestrogen level continues to
increase until it triggers the pituitary to
release a surge of Luteinizing hormone
(LH) which stimulates ovulation (the
follicle ruptures and releases the egg
and follicular fluid on the ovary
surface).
LUTEAL PHASE:
The ruptured follicle continues to
receive pulses of LH, turning it into a
small cyst, the corpus luteum, which
produces progesterone.
PROGESTERONE:
(i)
(ii)
(iii)
(iv)
Thickens the endometrium, developing glandular structures and blood vessels to supply a
developing embryo.
Shuts down FSH & LH production.
Raises basal body temperature (BBT) by half a degree, warming & infusing the uterus.
Cervical mucus secretion / texture improves & cervix moves lower in the vagina.
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Menstrual Hormones & Fertility
THE EGG:
Surrounded by a protective shell (zona pellucida) which is
further surrounded by a mass of sticky cells (cumulus
oophorous) which allow finger-like projections at the end of
the Fallopian tubes to move the egg into the tube.
The tubes are lined with cilia (small hairs), & together with
muscular contractions - provided fertilization occurs - these
direct the egg into the uterus which takes approx 6 days.
If the egg while in the fallopian tube is not fertilized, it
disintegrates and is absorbed. Fertilization needs to occur
within 24 hrs of ovulation.
FERTILIZATION:
Most healthy sperm can live in the female reproductive tract for several days. Therefore intercourse up to 3
days pre-ovulation may still result in fertilization. Upon penetration of the egg nucleus by the sperm the
genetic material of both fuse to form the required 46 chromosomes for development.
Cell division begins.
Hormonal Imbalance & Fertility
OESTROGEN DEFICIENCY
Generally in older women, from 35yrs there is a decline in oestrogen and subsequently ovulation.
Oestrogen levels can also be reduced by:
 Excess of wheat fibre in the diet, low body weight - 15% below normal, poor diet, anorexia, lack of
Vit.A, excess exercise, smoking, antibiotics, contraceptive pill long term, all may cause
menstruation to become intermittent or stop.




Symptoms:
Irregular Periods, intercourse difficulty, vaginal dryness, hot flashes, night sweats, bladder
infections, premature ageing.
Treatment:
Phyto-oestrogens – plant compounds resembling oestrogen but weaker. These attach to oestrogen
receptors on body cells supplementing oestrogen. This helps reduce the heaviness & length of the
menstrual flow, rebalance the oestrogen/progesterone ratio, lengthen the Luteal Phase and inhibit
oestrogen dependent carcinogens that can cause breast cancer.
They are also rich in immunity-enhancing flavonoids, vitamins, minerals, amino acids, essential
fats and fibre.
Food sources:
Fruit, green veg, grains beans, pulses, alfalfa, oats, hops, cherries, etc.
(Soya is a rich source but may have contraceptive properties – not recommended.)
Herbalist – low dose natural oestrogen
PABA – para-aminobenzoic acid, a component of Vit.B-complex, stimulates the pituitary to
produce oestrogen.
Medical Acupuncture Clinic – www.med-acu.com
Menstrual Hormones & Fertility
PROGESTERONE DEFICIENCY
Progesterone production declines during Perimenopause, when ovulation also declines. Insufficiency can
occur due to:
 Ovulation failure, or insufficient length of time of progesterone production in the Luteal Phase – it
is also known as Luteal Phase Defect (LPD). Pregnancy is unlikely unless the Luteal Phase is
longer than 10days. Initially, progesterone maintains pregnancy, so deficiency may cause
miscarriage.
 It may also occur after pill use, miscarriage, or breastfeeding.
 It is more likely in polycystic ovary syndrome (PCOS).
 Can be caused by faulty secretion of other reproductive hormones – FSH, LH, or Prolactin.
 It is linked to endometriosis and menstrual cycle difficulties.
Symptoms:
Include painful or lumpy breasts, menstrual cycle headaches, anxiety, irritability, sleeping
problems, unexplained weight gain, PMS (premenstrual syndrome), bleeding between periods and
reduced libido.
Solutions:
Prescribed medications, Vit.B6 & E, magnesium, evening primrose oil, Vitex Agnus Castus
(herbal).
Treatment:
Reduce stress, exercise but not excessively, increase low body weight.
OESTROGEN EXCESS:
Environmental oestrogens (found in pesticides,
plastics and PCBs – chemical pollutants in water, air
and soil) are structurally similar to body oestrogen,
with similar action, upset the oestrogen /
progesterone balance.
Diet: too much refined carbohydrate and saturated
animal fat, high fat diet, obesity, lack of exercise and
too little fibre contributes. Eat fresh fruit, esp apples
and pears, veg, whole grains, oats and oat bran
(NOT wheat bran – may irritate intestine lining).
Organic is best.
Symptoms:
Puffiness, bloating, water retention, rapid weight gain, breast tenderness, heavy bleeding, mood swings,
sleep problems, migraine, flushed face, reduced libido, foggy thinking, endometriosis, fibroids, gall
bladder problems, poor blood sugar control, and hypothyroidism.
Treatment:
Low fat, high fibre, nutrient rich diet with phyto-oestrogens will improve hormonal balance. Veg like the
cabbage family increase the rate the liver converts oestrogen to a water soluble form for excretion.
Increased protein improves oestrogen metabolism in the liver, and Vit.B6 reduces the effects of oestrogen
excess.
Medical Acupuncture Clinic – www.med-acu.com
Menstrual Hormones & Fertility
ANDROGEN EXCESS (MALE HORMONE)
Usually associated with PCOS
(polycystic ovary) in women, also
poor diet – excess sugar, refined
foods and simple carbohydrates
(sweets, jams, tinned fruit, chocolate,
etc.), adrenal disorders, steroids, and
obesity.
Symptoms: acne, ovarian cysts,
ovarian tumor, excess body hair,
unstable blood-sugar levels, thinning
head hair, mid-cycle pain, irregular
periods.
Treatment: High-fibre vegetarian diet
low in saturated fats and high in
phyto-oestrogens. Medical help.
CORTISOL
Produced in the adrenal glands over the kidneys, it also
increases oestrogen, If deficient, some of the causes
include long-term stress, and poor nutrition.
Stress causes glucocorticoids (steroid) levels in blood to
rise, this activates the hypothalamus to secrete
corticotrophin-releasing hormone (CRH), which causes
the pituitary gland to release adrinocorticotropic hormone
(ACTH) into the blood, which enters the adrenal glands
and causes release of cortisol.
This is a negative feedback loop, the excess cortisol
activates the brain’s glucocorticoid receptors and
suppresses CRH production. In chronically stressed
people, the loop no longer works resulting in excess CRH
& cortisol levels, causing depression.
Cortisol competes for receptor sites with progesterone, the
progesterone becomes less active and causes oestrogen
dominance over time.
Symptoms:
Unstable blood-sugar levels, chronic fatigue, candidiasis, PMS, libido loss, reduced immunity, low blood
pressure, headaches, depression.
Treatment: Reduce sugar, tobacco, caffeine, alcohol and eat a balanced diet. Use relaxation techniques.
Medical Acupuncture Clinic – www.med-acu.com