Mild, Missed and Misunderstood: Subtle Hormonal Imbalances & Infertility

Your hormonal health is of utmost importance to your overall health, as well as your fertility.

A Little Means a Lot

Hormones are extremely powerful substances produced in minute quantities in our bodies. Small disruptions in hormonal balance can make a huge difference to how we feel. Just consider the way you or your friends have suffered with PMS, mood swings, acne, menopause, menstrual cramps or infertility and you can appreciate how hormonal health becomes a key factor in our very quality of life.

Check with your naturopathic doctor or functional medicine physician to rule out hidden hormonal imbalances

These all-too-common (but not normal) symptoms are signs of hormonal havoc.

When It’s Not As Obvious

Hormonal issues can also be relatively symptom-free, hiding subtly just below the surface. Sometime, the only outward sign of a hidden hormonal imbalance is infertility.

In fact, subtle hormonal imbalances are one of the most common hidden causes of “unexplained infertility” in the women I see in my practice.

For example, let’s look at what it can mean if you have sub-optimal or “missed” low progesterone.

Suboptimal Progesterone 

Progesterone is known as “pregnancy hormone” because it prepares your uterus for implantation and early pregnancy. It’s produced in your ovaries, adrenal glands, and once pregnancy occurs, it’s produced by the placenta.

The current definition of low progesterone is less than 35 nmol/L (He et al. 2015). However, in practice, I have found that women with even lower progesterone levels have been told their low result is “nothing to worry about” or even that “it’s normal”.

Low progesterone can cause of infertility and miscarriage (Andrews et al. 2015). And if pregnancy does occur, low progesterone in the first trimester of pregnancy predicts higher risk of high blood pressure during your pregnancy and of having a baby with low birth weight (He et al. 2015). (Low birth weight places your child at risk of several other future health problems).

Regardless of why it gets missed, low progesterone is one of the most common hidden causes of infertility because it gets missed.

Fortunately, like other hormonal imbalance issues, there are ways to successfully treat low progesterone naturally and/or with conventional medicine.

4 Signs You Could Have Low Progesterone Function – Even If Your Blood Work Is Normal

1 – lower than expected BBT (basal body temperature) spikes, or no spike, at the beginning of the second half of your menstrual cycle

2 – unstable BBT readings in the second half of your menstrual cycle

3 – spotting between periods

4 – spotting just before your period

Treating Low Progesterone/Luteal Phase Deficiency

If your progesterone level is recognized to be low, you may receive the diagnosis of luteal phase defect or luteal phase deficiency. This means your progesterone level isn’t high enough to keep the second half of your cycle healthy enough to sustain early pregnancy.

To boost progesterone production naturally, we may consider one or more of the following treatments:

Chaste tree – also known as Vitex agnus-castus, this medicinal plant is an effective, first-line therapy for low progesterone, luteal phase deficiency, PMS and irregular periods. Some naturopathic doctors recommend chaste tree in the luteal phase or 2nd half of your cycle only, although it can be used safely throughout the cycle especially if you have PMS, irregular periods or PCOS.

Adrenal support – the adrenal glands’ priority is stress survival. They produce progesterone from the hormone precursor, pregnenalone, and then covert it into cortisol – stress hormone. When you’re under stress, your adrenals will steal more pregnenalone to make cortisol, so there’s less of it available to make progesterone (McCulloch 2012). We call this the “Cortisol Steal” and it’s really important to dampen it down with proper care for your adrenals, along with stress reduction especially while you’re trying to conceive.

Nutrition – starting from a whole foods Fertility Diet foundation with plenty of clean protein and healthy fats to build hormones, studies have shown that B vitamins, magnesium, vitamin C and fish oils effectively support increased progesterone production (McCullogh). Higher dietary selenium intake has been associated with reduced risk of luteal phase deficiency (a product of low progesterone) (Andrews et al. 2015). Melatonin (1-3mg) taken at bedtime has been used to boost progesterone (McCulloch), and is also of great benefit to healthy sleep.

Acupuncture – studies have shown that acupuncture treatment can effectively restore hormonal balance, regulate the menstrual cycle, and promote the body’s ability to support early pregnancy.

Be sure your physician or naturopath takes a look at your luteal phase progesterone before you try to conceive so that you can take the appropriate steps to optimize your levels of “pregnancy hormone” from the outset.

Other Hidden Hormonal Havoc-Wreakers

There are a few other hidden obstacles that I commonly see in my practice. One of them is environmental toxicity.

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McCulloch F (2012). Supporting the luteal phase with integrative medicine. NDNR. Available at:

He et al. Association of maternal serum progesterone in early pregnancy with low birth weight and other adverse pregnancy outcomes. J Matern Fetal Neonatal Med. 2015 Sep 3:1-6. [Epub ahead of print]

Andrews et al. Dietary factors and luteal phase deficiency in healthy eumenorrheic women. Hum Reprod. 2015 Aug;30(8):1942-51. doi: 10.1093/humrep/dev133. Epub 2015 Jun 16.