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Functional Medicine Approach to Infertility

6 to 7 Million Women Suffer with Infertility

According to the Centers for Disease Control (CDC), about 10 percent of women (6 to 7 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.
Infertility can be caused by numerous things. There are of course the pathological reasons which need to be ruled out by an obstetrician. But most infertility issues seem to stem from an inability for the female hormones to be cycling correctly. When they don’t cycle correctly, ovulation does not occur at the appropriate time (or at all), and a pregnancy either doesn’t happen or can’t be sustained. When we think of infertility we think of one thing, low progesterone. While that is one of the main players, we also have to think about the complete orchestra that is the body’s sex hormone production and one of the other important players is cortisol.
Cortisol is a glucocoricoid, or steroid, that is made mainly in the adrenal glands which are above the kidneys. Cortisol’s role is to help the body respond to a stressful event. This stressful event could be inflammatory (like from an injury, or foods), infections in the GI tract, or emotional (like a divorce, death in the family, graduate school, etc.). Cortisol’s NORMAL response is to be elevated in those stressful times for energy demand immune regulation to help combat these exogenous stressors to the body. Infections, poor eating habits, blood sugar swings, not enough sleep or exercise all “demand” more on our body so cortisol comes to the rescue and is produced at higher-than-normal levels.
Every drop of this stress hormone is made from progesterone. Therefore all of the cortisol your body makes and demands when you are under stress can deplete your progesterone levels. The more stress you are under the more female hormone imbalances will occur as your progesterone levels drop. Progesterone is the ‘pro-gestational’ hormone, it keeps the uterine lining intact through the second half of the menstrual cycle. If more stress hormone is demanded, the more progesterone is depleted therefore decreasing ‘pro-gestation’ and the uterine lining does not stay intact (this can lead to early bleeding, not sustaining a pregnancy, etc.).
There is hope!In my office, I commonly observe this flucuation of the stress hormone which is labeled ‘adrenal fatigue’ and is a common occurance with women dealing with infertility or hormone problems.
I’m not only concerned with your progesterone level one time per month, I’m interested in all the cascading hormones throughout your entire cycle. It’s important to know how much progesterone you make in a cycle, how much estrogen, when do the different levels spike to promote ovulation, what is the stress hormone doing and is it causing a progesterone ‘deficiency’. That’s a lot of information that can not be determined by one monthly level of progesterone.
When I help a woman with a history of infertility, miscarriage, or even pre-conception care, it is my goal to observe this orchestra of hormones and figure out what may be contributing to the problem. This is done through three different lab tests: a cortisol or ‘stress hormone’ rhythm, a month-long female hormone cycle that maps the levels of estrogen and progesterone, and a GI stool test to rule out any underlying infections which may be making this whole process worse. From all of this information, I put together a plan for the woman to help her body ‘re-set’ her hormone rhythms and normalize function.

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Dr. Zac Watkins has had success in correcting infertility. Contact our clinic today!