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Hormonal Imbalance and its Impact on Fertility

Updated: Jan 11

Woman Trying to Balance

Striking the right balance in female hormones has an incredible influence on health, well-being, and the ability to get pregnant.  Finding a balance between the vital reproductive hormones estrogen and progesterone is critical for achieving pregnancy.  Whether you have regular or irregular periods, knowing your actual hormone levels can provide valuable insight as to where you stand from a fertility perspective.


The Role of Estrogen in Reproductive Health

Estrogen is a critical reproductive hormone that influences mood, regulates periods, promotes ovulation, and sustains libido (sex drive).  Rising levels during your cycle indicate the start of your fertile window.  Estrogen dominance is a hormonal imbalance in which estrogen is elevated, which inversely causes low progesterone levels. Low estrogen levels might be due to lifestyle choices (activity and diet) and underlying thyroid conditions.


Common Causes of Estrogen Dominance

Estrogen dominance is when estrogen levels are higher than usual, especially in the follicular phase.  This phase in your cycle is designated by the start of your period until the day you ovulate. Estrogen dominance can be caused by:


  • PCOS

  • Endometriosis

  • Fibroids

  • Obesity (High BMI)

  • Ovarian Tumors

  • Liver Disorders

  • Medications

  • Antibiotics

  • Oral Contraceptive Pills


Elevated Estrogen Effects on Ovulation and Menstrual Cycles

To balance estrogen, understanding and treating the underlying cause is essential.

Women who have an estrogen-dominant condition, such as PCOS or endometriosis, might have irregular or absent periods. Other symptoms might include increased weight gain, especially in the hips or thighs, fatigue, decreased sex drive, and mood changes.  For more insight into how to treat these conditions, visit our forum, which has guidance from experts, including nutritionists and medical doctors. 


Low Levels of Estrogen

Women might have low levels of estrogen for a myriad of reasons. Common causes include malnutrition (most often stemming from an eating disorder), extreme exercise, thyroid disease, high levels of stress, and elevated prolactin.  Symptoms of low estrogen may include amenorrhea, which is not having a period for three or more months.  Other symptoms include painful sex, headaches, depression, hot flashes, and decreased bone density.

Woman outdoors exercising and  stretching


Progesterone and Pregnancy

Progesterone regulates your period, prepares your body for conception, and helps sustain a viable pregnancy.  It should steadily increase after your ovulation and will remain increased if you become pregnant.  It will decline if pregnancy does not occur; the decrease in progesterone level will induce your period.


Combating Hormonal Imbalances

Achieving hormonal balance might help women get pregnant. Experts recommend correcting underlying hormonal imbalance conditions before getting pregnant, which might help prevent complications during pregnancy.


Treating  Estrogen Imbalance

Treating the underlying condition that contributes to estrogen imbalance often helps manage and stabilize levels.  For instance, women with PCOS might benefit from supplements such as inositol and nutritional management with an anti-inflammatory diet that balances glucose and insulin levels. Women should also attempt to check their thyroid levels, as this is a key indicator of reproductive health.  


Women who suffer from body dysmorphia, a debilitating psychological condition that can lead to anorexia, bulimia, and extreme forms of exercise, should seek guidance from a therapist and nutritionist to help treat these conditions.  These conditions not only affect reproductive health but affect many other body systems and ultimately be life-threatening. The National Eating Disorder Association (NEDA) offers resources for women who suffer from these conditions. 


Combating  Progesterone Imbalance

Since estrogen and progesterone have an inverse relationship, the causes of low progesterone are the same causes for high estrogen, such as PCOS, endometriosis, and fibroids.  If you are under the care of a fertility clinic, oftentimes, they check progesterone after ovulation and supplement with synthetic progesterone if levels are low.  However, women who are not under the care of a fertility doctor also have options to increase their progesterone levels. Some dietary guidelines include increasing the following foods:


  • Avocado

  • Eggs

  • Extra Virgin Olive Oil

  • Salmon

  • Walnuts

  • Chia Seeds

  • Chicken

  • Dark Chocolate

  • Full-Fat Dairy

Foods to eat to treat low progesterone levels

Another critical component besides dietary modifications is supplements.  Studies indicate that vitamins E and K2 regulate estrogen and progesterone.  Taking a comprehensive prenatal vitamin with ODI dosing will help ensure you get adequate levels of both. Bear in mind that taking a holistic route in terms of diet and key supplements takes about 2-4 months to see the full effect take place.  As a result, patience is critical.  If you have been trying to conceive for over a year, and holistic measures have not worked, further evaluation with a specialist is recommended.


Toxins and Hormones

Removing toxins, such as endocrine-disrupting chemicals (EDCs), in the environment helps tackle some hormone imbalances, as EDCs mimic hormones. Bisphenol A (BPA), phthalates, pesticides, and parabens are common toxins that affect fertility.  The Environmental Protection Agency, Environmental Working Group, and The Endocrine Society are making strides to reduce these toxins and educate the public on minimizing EDCs in your immediate environment.  Please visit sites for additional resources.


Tracking Hormones

The fertility field is exploding with a whole avalanche of products designed to help women understand their hormones better.  For women who are not ready to see a fertility doctor but want more insight into their hormone levels, a good place to start is to get an at-home hormone tracker. There are many on the market.  I tested quite a few brands with digital options, and the one that always came out on top was the Mira Monitor.  Having worked in fertility centers, this comes incredibly close to attaining levels comparable to what is run in-house at fertility labs.  What makes it so similar is that you get numerical values for critical hormones, including estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).   You can download the Mira app and synch your phone, which allows you to view your hormonal curve and identify any underlying hormonal imbalances, along with pinpointing ovulation and fertile windows.

Mira Hormone Tracker

The intricate relationship between hormonal imbalance and infertility is a complex and often challenging journey. Hormonal factors play a crucial role in reproductive health, and achieving balance is vital in the pursuit of parenthood. However, it is important to remember that infertility is not an insurmountable obstacle. With advancements in medical technology, the support of knowledgeable healthcare professionals, and a proactive approach to self-care, there is hope for those facing hormonal challenges. By embracing a holistic approach that encompasses medical interventions and lifestyle modifications, individuals can empower themselves to navigate the path toward fertility.


Cleveland Clinic. Hormonal Imbalance.


National Eating Disorder Association (NEDA).


Silvia Vannuccini, Vicki L. Clifton, Ian S. Fraser, Hugh S. Taylor, Hilary Critchley, Linda C. Giudice, Felice Petraglia, Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome, Human Reproduction Update, Volume 22, Issue 1, January/February 2016, Pages 104–115,

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