There are variable causes for infertility. Current estimates reveal that at least 10-15 percent of couples in the US are infertile, despite having unprotected sexual intercourse for at least 12 months. Causes for infertility may be due to a single causative factor in the female or the male or it may be due to a combination of factors that prevent a pregnancy from developing or continuing. Even though many therapies have been developed in conventional medicine for infertile couples, the ability to conceive often remains low. The causes for infertility in about 30% of cases are directly related to the male, while another 30% are directly attributed to the female. For the remainder, infertility may be attributed to both partners, or in many cases, the cause is not identified. When couples present with infertility issues to a healthcare professional, there is usually an extensive workup done, unfortunately, in many partners no cause is ever identified.
In the past decade it has become evident that perhaps another cause of infertility may be adrenal fatigue, a condition that is not frequently considered in the differential diagnosis, and hence the possibility is never entertained.
Could adrenal fatigue be one of the causes for infertility? Adrenal fatigue is a condition that presents with a number of signs and symptoms indicating under-functioning of the adrenal glands and the neuroendocrine system. The degree of function is usually below the level necessary for healthy living. Adrenal fatigue has many causes including almost any type of viral, bacterial or fungal infection. Chronic stress is one of the most common central causes. Adrenal fatigue usually does not present overnight but has a gradual onset. The fatigue is often continuous and not relieved by sleep or rest. Physically there are no specific findings of adrenal fatigue except that most individuals will complain of generalized tiredness or feel down. Some individuals may obtain partial relief after drinking a caffeinated beverage, but the relief is often short-lived.
The exact number of people affected by adrenal fatigue is not known because most individuals never seek medical care they just assume it is work related or stress induced fatigue. In conventional medicine, adrenal fatigue is often not recognized as a distinct clinical entity, chiefly because there are no definitive methods to make the diagnosis.
Over the past years, more evidence seems to indicate that adrenal fatigue not only results in fatigue but also affects a number of organs in the body. The adrenal gland is a major producer of several endocrine hormones that play a role in homeostasis, the fight-or-flight response, metabolism, maintenance of blood pressure and functioning of the sex organs. When adrenal fatigue occurs, it appears that all these other systems are affected, but not necessarily all at the same time. One area that has never been well studied is the role of adrenal fatigue in infertility. It is well known that the adrenal glands secrete both estrogen and progesterone, the two female sex hormones that are essential for a normal pregnancy. Numerous anecdotal reports seem to suggest that in some women, it may be adrenal fatigue causing infertility.
It now appears that many women who present with complaints of the reproductive system also complain of fatigue at the same time, and some of these women also complain of difficulty trying to conceive. After a medical workup, no obvious cause for the infertility is ever found. However, because of the presence of extreme fatigue, it is now believed that the adrenal gland may be playing a primary role in infertility. It is believed that the under-functioning of the adrenal gland may lead to a lowered production of estrogen and progesterone, which can either prevent a pregnancy or may be the cause of a spontaneous abortion. For starters, to get pregnant, a balance must be struck between your reproductive hormones to ensure ovulation occurs; and once that occurs, that the ovaries are ready to receive a fertilized egg. To sustain a pregnancy, the female requires a continuous production of reproductive hormones to ensure stability for the fetus and proper growth.
While the ovaries produce many of these hormones, the adrenals also work closely with the ovaries to produce reproductive hormones as well. When the adrenals are weak, the ability to produce these hormones is compromised. What results is a body that is not at optimum capacity to receive a fertilized egg, thus infertility may arise. In some cases, it has been observed that the initial pregnancy is viable, but then suddenly fails, resulting in miscarriage, most frequently during the first trimester. Again, it is suspected that adrenal fatigue may be the cause. The cause of adrenal fatigue before or during early pregnancy may be stress, an infection, poor nutrition, any recent surgery, lack of certain vitamins and minerals or use of a supplement that may have suppressed the adrenal gland.
When adrenal fatigue occurs, the uterus where the pregnancy implants can immediately sense the levels of sex hormones. If the levels of hormones are low or nontherapeutic, the uterus will not accept the fertilized egg for implantation. This is largely related to progesterone deficiency, either on an absolute or relative basis.
So when a female presents with a history of infertility it is essential to assess for adrenal fatigue. This is simply done by asking about the regularity of the menstrual cycle, the length of the menstrual cycle and changes in body temperature; which can indicate if ovulation is occurring normally. Furthermore, a female who presents with a history of abortion or miscarriage should complete a comprehensive assessment to ensure that adrenal fatigue is not the culprit.
The adrenal glands are part of a larger network of organs and systems, called the NeuroEndoMetabolic (NEM) Stress Response, that work together to combat stress. The NEM is composed of six circuits: the hormonal, bioenergetics, cardionomic, neuroaffect, inflammation, and detoxification circuits. The adrenals are part of the hormonal circuit, which also includes the thyroid, female ovaries, and male testes.
For women, the part of the hormonal circuit that deals directly with reproduction is the ovarian-adrenal-thyroid (OAT) axis, and its job is to keep the balance of hormones needed for reproduction. If it gets disrupted, so does reproduction, but it can also affect every other aspect of health, from fatigue to body temperature. A disruption in the OAT axis is what creates symptoms like PMS, low libido, hair loss, fibrocystic breast disease, irregular menstruation, miscarriages, and infertility.
Estrogen dominance, which is the relative dominance of estrogen to progesterone, is a very common issue that arises when the hormonal circuit is dysregulated. Estrogen and progesterone act as antagonists, keeping each other in check, and your body needs them to stay in balance in order to function properly. But weight gain, stress, a sedentary lifestyle, exposure to environmental estrogens, adrenal fatigue, and an unhealthy diet can all lead to estrogen dominance and hormonal imbalance.
Thankfully, if these factors are corrected, that will help your hormonal circuit to get back into balance and increase your fertility levels.
A recent study conducted by the Robin Research Institute of the University of Adelaide in Australia looked at the diets of 5,598 women from Australia, New Zealand, Ireland, and the UK. The study, which was published by the peer-reviewed ‘Human Reproduction’ medical journal, concluded that the women in this study who ate fast food four or more times a week had their infertility risk increase from 8% to 16%, and took a month longer to get pregnant, while those that ate fruit three or more times a day increased their chances at getting pregnant. Those that ate the least amount of fruit increased their infertility risk from 8% to 12% and took about half a month longer to get pregnant.
These findings may even be underreported since what the researchers looked for only included fast food from fast food restaurants and did not include fast food bought from supermarkets, such as microwave meals or frozen pizzas. The study also did not look at how diet affects male fertility, but it’s safe to say that the outcomes will have many similarities, and that the causes for infertility in women, especially those linked to diet and lifestyle, are also shared by men.
A plant-based diet that includes a lot of raw and organic fruits, as well as superfoods and fermented foods, activates hormones. It’s also very helpful for increasing energy levels - and healthy reproduction, from start to finish, needs a lot of energy. But, if you have AFS, you will have to find a balance when eating fruits because it is advisable to avoid high-glycemic index fruits that will cause blood sugar spikes and crashes, and also certain fruits that have a lot of potassium such as bananas, since your sodium-potassium ratio may be out of balance.
Also, it’s best to find out which component of the OAT axis is dominant in order to come up with a more individualized plan for your diet and treatment. Those with ovarian dominance tend to show more of the estrogen dominance symptoms we covered, as well as significant brain fog. If that’s you, then you need to keep your protein intake higher relative to your carbohydrate intake. Those with adrenal dominance will exhibit more emotional symptoms, such as anxiety and irritability. If that’s you, you should eat more protein and fat. Those with thyroid dominance usually present severe fatigue and low energy levels. If that’s you, then your diet should be more on the vegetarian side.
Generally, hormones respond very well to a healthy diet, and a good fertility diet will take into consideration your health as a whole, and not just one aspect. It’s always a good idea to get guidance on this journey, at least in the beginning, and to supplement when needed.
It is important to remember that infertility due to adrenal fatigue is often reversible. The most important thing you need to do is seek the assistance of an alternative health care practitioner who understands the pathology behind this problem. It is important to know that there are no blood tests that can test for adrenal fatigue with certainty. The levels of the sex hormones may not be sufficiently depressed in the bloodstream to show up clinically. The determination must be made from your medical history and presence of other symptoms of fatigue.
Once the condition is identified, recovery from adrenal fatigue must include changes in lifestyle, diet, and use of supplements. In addition, you will have to refrain from smoking and avoid excess consumption of alcohol. The treatment is individualized for each person but overall can also reduce the variable causes for infertility. Once the process starts, it may take a few months to upwards of one to two years for your menstrual cycles to normalize, after which you can begin the process of conceiving. Unlike traditional medicine, there are no expensive invasive tests that you need to undergo because in most cases they will just come up negative. The success of your ability to reverse infertility depends on the experience of your naturopath - so the first step is to find the right provider.
© Copyright 2016-2018 Michael Lam, M.D. All Rights Reserved.
Good question. There are several aspects to a diet for AFS are very helpful for healthy pregnancy also. Avoidance of inflammatory foods such as caffeine, alcohol, sugar, trans-fats, processed food, etc. Eating smaller meals to keep blood sugar more even throughout the days. This should give you enough calories to support a healthy pregnancy.
It is important to get yourself healthy before you get pregnant. Improve your AFS symptoms and reducing stress in your life can help. Having a healthy lifestyle by eating the proper food and exercise in moderation is important to keep your body healthy before pregnancy and minimize causes for infertility.
There is a close correlation between AFS and fertility. The adrenals help to keep your ovarian hormones in balance, which is important for fertility. Stress, being overworked, and fatigue can all affect fertility. Proper supplementation with the help of a professional should help to get your body ready for successful conceiving.