How to Balance Hormones for Fertility (and What Does That Mean, Exactly?)

If you’ve ever blamed your hormones for breakouts, bloating, mood swings, or missed periods, you’re not wrong. But “hormone balance” has become one of those wellness buzzwords that gets thrown around without much explanation.

Let’s take a deep dive into how to balance hormones for fertility (using realistic, evidence-based suggestions), and what an imbalance can mean for your overall wellness and reproductive health. 

At the most basic level, hormones are chemical messengers made by the endocrine glands (your ovaries, thyroid, adrenals, pituitary, and pancreas) that travel through your bloodstream to tell different tissues what to do. (Think of hormones as messengers sent from one part of your body to another.)

Together, all of these glands and signals make up your endocrine system (which is your hormonal system), and it’s one of the most powerful regulatory systems in your body.

Hormones influence almost everything, including:

• Menstrual cycles and ovulation
• Mood and mental health
• Energy and metabolism
• Sleep and circadian rhythm
• Appetite and blood sugar
• Libido and fertility
• Skin, hair, and body composition
  

Estrogen, progesterone, testosterone, cortisol, insulin, and thyroid hormones are all a part of an interconnected network. When one shifts, others respond, and this is why symptoms rarely show up in isolation.

Hormones are the main event for both females and males when it comes to fertility.

Ovulation and spermatogenesis (AKA sperm development) depend on precise communication between the brain (specifically the hypothalamus and pituitary) and reproductive organs. Medically, it’s referred to as the hypothalamic-pituitary-gonadal axis. Fluctuations along this axis alter the hormones secreted by each gland, leading to a range of effects throughout the body. 

The endocrine or hormonal system regulates nearly every system in the human body. From conception, hormones are what drive development. And beyond the critical role they play in growth and development, hormones are also responsible for metabolism, mood, immunity, stress, sleep, digestion, circulation, temperature regulation, healing, and fluid balance–truly influencing every aspect of our health. This is also why an imbalance in one hormone can create a domino effect on the rest of our body, and how hormones in balance create fewer symptoms in the body. 

There’s a certain “Goldilocks” level we need to achieve when it comes to our hormones. When hormones are too low or too high, the body will function less optimally. Let’s break down some symptoms we might see when fertility hormones are out of balance.

Thyroid (TSH):

• Too high: Elevated levels of thyroid-stimulating hormone (TSH) are linked to hypothyroidism, a condition in which the thyroid gland is underactive and failing to produce enough thyroid hormone for the rest of the body. This can lead to constipation, weight gain, hair loss, heavy periods, and fertility issues. Women with unexplained infertility seem to have higher levels of TSH than women without unexplained infertility. 
• Too low: On the flip side, low TSH levels are linked to hyperthyroidism, when the thyroid gland makes too much thyroid hormone. Similarly, this can cause issues with menstruation and fertility.

Testosterone: 

• Too high: In females, elevated testosterone may be a result of PCOS. When testosterone is too high relative to estrogen, this shuts off ovulation and can lead to irregular cycles. 
• Too low: In females, this may be a result of long-term stress. In both females and males, low testosterone leads to poor bone and muscle health and low libido. In males, low testosterone has been linked to decreased rates of fertility.

LH/FSH: 

• Doctors tend to consider LH and FSH together, and their ratio. In females, when LH is too high, this is considered a soft marker for PCOS (it’s like the brain is telling the ovaries to ovulate, but they’re not listening).
• Elevated FSH levels, on the other hand, are often seen as perimenopause begins to emerge. 

Like most aspects of our health, our diet, lifestyle, and environment have a big influence on how our hormones function.

Blood sugar imbalances (from diets high in sugar, refined carbs, and processed foods) can lead to insulin resistance. For women, this leads to higher testosterone levels, shutting off ovulation, and therefore declining progesterone levels. For men, this causes the opposite: plummeting testosterone levels, increasing their risk for metabolic syndrome, and contributing to poor sperm quality. 

Not consuming enough calories, especially when paired with extensive physical training, can also be detrimental. When the body doesn’t have enough energy, the brain reduces its secretion of the hormone gonadotropin-releasing hormone: the master sex hormone producer. The result? Menses gets completely shut down, leading to a condition called hypothalamic amenorrhea.

• Diets high in sugar, processed foods, and refined carbs may lead to insulin resistance
• Not eating enough for your lifestyle can mess with your cycle

Elevated cortisol, caused by stress and chronic nervous system dysregulation, suppresses reproductive hormones, disrupts ovulation, and drains progesterone. Functionally, this makes sense: the female body won’t prioritize fertility if it’s in a state of stress—its main priority is survival. While this compensatory mechanism is protective, it’s not ideal when you’re trying to get pregnant or simply want to feel hormonally balanced. (The key here is chronic stress—regular day-to-day stresses are normal and, when managed, part of a healthy immune response.)

Similarly, poor sleep is associated with disruptions in hormones like cortisol, ghrelin and leptin (our hunger and satiety hormones), and even insulin. The result of a poor night’s sleep isn’t just fatigue–it’s actually why you crave calorically-dense, carbohydrate-rich foods the next day. Your body is screaming it’s hungry and internally, you are more insulin resistant. The effects of this long-term are detrimental for metabolic and reproductive health.

Lastly, environmental contributions can’t be ignored, with clear evidence pointing to the role of endocrine-disrupting chemicals and their impacts on our metabolic and reproductive health. Endocrine-disrupting chemicals (EDCs) are chemicals that resemble our natural hormones but disrupt their function. Chemicals like bisphenol, phthalates, parabens, as well as pesticides, are the main culprits of our EDC exposure. 

• Chronic stress can suppress reproductive hormones
• Poor sleep can disrupt hormones and lead to negative lifestyle choices that further affect hormone balance
• Endocrine-disrupting chemicals disrupt hormone function

Fortunately, there’s a lot we can do to help bring our hormones in balance. The key? Focus on foundations. 

Prioritize a healthy diet: A Mediterranean-style diet that focuses on whole foods, lean proteins, healthy fats, whole low glycemic grains, and lots of fruits and vegetables is essential. This anti-inflammatory diet can help to control blood sugar and improve insulin sensitivity, while offering an array of antioxidants and high fibre to promote detoxification of harmful chemicals that can otherwise disrupt hormones and impact semen quality. 

Nourish your liver: Our liver is the primary organ involved in detoxification. Not only is it eliminating harmful chemicals and pollutants we come in contact with, it’s also detoxifying excess hormones. The liver does this every day! But it also requires essential nutrients in order to operate at peak performance (think: amino acids from proteins, B vitamins from whole grains and dark leafy greens, and antioxidants from fruits and vegetables). Just another reason why focusing on diet is critical for hormonal balance. 

Consider supplements that support hormone balance: From minerals to herbs, there’s a lot that can support hormonally related symptoms. 

1. B Vitamins: These essential nutrients help our liver function, promoting detoxification and hormones in balance. B vitamins are used by the body to convert our food into energy, and are involved in the creation of mood-regulating and sex hormones. 
   
   
2. Inositol: This B-vitamin-like compound is naturally occurring in our body, but some individuals make less of it. It’s known for balancing testosterone levels and improving insulin resistance, and in females, it regulates the menstrual cycle. 
   
   
3. Magnesium: A mineral involved in over 300 biochemical processes (that’s a lot) that is, more often than not, depleted in our bodies. A diet high in sugar requires even more Magnesium to function. It can improve insulin resistance in those with elevated glucose, and supplementation can promote deeper sleep, improve cortisol response, and support healthy progesterone levels. It’s also essential for activating Vitamin D. 
   
   
4. Vitamin D: A key nutrient for keeping blood sugar regulated by improving insulin sensitivity. It’s also linked to fewer PMS symptoms by supporting healthier hormone balance and lowering inflammation. Lastly, it plays a role in both male and female fertility by supporting better egg quality and healthier sperm.