According to The Center for Disease Control and Prevention, 6.7 million American women between the ages of 15-44 have an impaired ability to get pregnant naturally and carry a baby to term. Western medicine tells us the most common cause of infertility in women is anovulation—the ovary does not release an egg during menstruation. Doctors will prescribe infertility treatments and female hormone imbalance therapies, but these are not necessarily addressing the main issue. While anovulation is definitely a hormonal problem, it is stress hormone issue before it is a female hormone issue.
The circadian rhythm is a daily rhythm created by our exposure to light and dark. It is also impacted by the things we do or don’t do on a daily basis, things that directly or indirectly cause us stress. The circadian rhythm also affects the levels of estrogen and progesterone created during a woman’s monthly rhythm.
As part of the normal female cycle, the growth hormone estrogen rises in the middle of the month and then drops down just before ovulation. This surge in estrogen causes the uterine lining to grow and an egg to be released from a follicle. Progesterone (“pro gestation”) levels are elevated in the middle of the month just after ovulation, and they should stay high until the end of the month. In pregnancy, progesterone is the hormone needed in order for the body to “hang onto” a growing fetus.
If women are unable to conceive and are experiencing anovulation, doctors usually prescribe synthetic hormones. These treatments mimic the estrogen surge (so that an egg can be released) and the progesterone longevity (so pregnancy can be maintained). However, synthetic hormones are not usually covered by insurance and can have unwanted side effects. Modern medicine is treating the female hormone imbalance, but they are missing the reason the hormones are imbalanced in the first place.
In my practice, I have never seen female hormones become imbalanced on their own. Likewise, my mentor Dr. Dan Kalish, who has been correcting female hormone imbalances and helping women get pregnant for over 20 years, has experienced the same. Female hormones are always intertwined with the stress response, an impaired circadian rhythm due to an abundance of the stress hormone cortisol.
A hormone called DHEA creates all forms of estrogen. A second hormone, cortisol, is created by progesterone. Every molecule of estrogen in your body comes from DHEA, and every molecule of cortisol in your body comes from progesterone. In turn, the adrenal glands produce DHEA and cortisol in response to stress, and progesterone and estrogen are created in the ovaries.
The body is designed to prioritize survival over reproduction. If you are under stress, your DHEA and cortisol levels increase while estrogen and progesterone levels drop. To put it simply: the more stress, the lower the sex hormones. This has not changed since the beginning of the human race. If a tribe was wandering around out in the Sahara Desert because they had no food, the women were under stress and would not be able to get pregnant. The body will always put survival above reproduction.
You might not be starving, but you might be experiencing one or more of the three primary stressors: emotional, dietary, pain or hidden inflammation. And when we are stressed, no matter how small or big it might seem, we are in survival mode. If a disruption is perceived by the body as stress, thus eliciting a stress (cortisol) response, there is a direct correlation with the body’s inability to ovulate.
Furthermore, stress can be compounding. The more unaddressed stress, the further one goes from the daily circadian rhythm and also the monthly rhythm. This causes more and more systemic hormone issues and health issues. The good news, however, is that “fixing” it, becoming healthy and fertile, is simple.
Functional medicine will test and then correct the daily and monthly rhythm, and a woman will become fertile. The same can be done for women with polycystic ovary syndrome (PCOS), premenstrual headaches, struggling with weight loss, or any other female hormone related problems.
Imagine you are an alien looking down at New York City for a year monitoring what you see at night. Every time you see a fire breaks out, you also see a red truck. You might assume the red trucks are starting fires, but we know this is not true. We know the people in the red trucks are firefighters—they are the emergency response team trying to put out the fires. It is the exact same with female hormones. Hormones are not the problem, they are the response team to our body’s 911 call of stress starting a fire.
If you are struggling to conceive, we will use functional medicine to provide the best infertility treatment around. Testing and then correcting the underlying cause of your infertility and putting out the fire is the key to starting a healthy pregnancy.