The Star Malaysia

Hormonal balance for fertility health

Know the types of hormones that help your body optimise fertility health and what to do if you suspect hormone imbalance.

- starhealth@thestar.com.my Datuk Dr Nor Ashikin Mokhtar 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 on

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 func- tion.

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.

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