Infertilility affects so many women these days. I decided to educate myself a little bit. Here is what I found out.
Luteinizing Hormone (LH) Luteinizing Hormone is secreted by the anterior pituitary gland in response to stimulation by gonadotropin releasing hormone, the same hypothalamic releasing factor that stimulates follicle-stimulating hormone (FSH) release.
LH affects gonadal function in both men and women. In women, large a surge of LH normally occurs at the midpoint of the menstrual cycle (ovulatory phase), this surge is believed to be induced by high estrogen levels. LH causes the ovum to be expelled from the ovary and stimulates development of the corpus luteum and progesterone production. As progesterone levels rise, LH production decreases. In menstruating women values vary in relation to the phase of the menstrual cycle.
Indications for testing:
- Distinguish between primary and secondary causes of gonadal failure.
- Evaluate children with precocious puberty
- Evaluate Male and female infertility as indicated by decreased LH levels
- Evaluate response t therapy to induce ovulation.
- Support diagnosis of infertility caused by anovulation as evidenced by lack of LH surge at midpoint of menstrual cycle.
Follicle-Stimulating Hormone. (FSH) is produced and stored in the anterior portion of the pituitary gland. In Women, FSH promotes maturation of the Graafian (germinal) follicle, causing estrogen secretion and allowing the ovum to mature. Gonadotropin-releasing hormone stimulated by a decrease in estrogen and testosterone levels. Gonadotropin-releasing hormone secretion stimulates FSH secretion. FSH production is inhibited by an increase in estrogen and testosterone levels. Decreased in PCOS (among other reasons)
Indications for testing:
- Assists in distinguishing between primary and secondary (pituitary or hypothalamic) gonadal failure.
- Define menstrual phases as a part of infertility testing.
- Evaluate ambiguous sexual differencing in infants.
- Evaluate early sexual development In girls younger than 9 or boys younger than 10.
- Evaluate failure of sexual maturation in adolescence.
- Investigate impotence, gynecomastia, and menstrual disturbances.
Prolactin – is secreted by the pituitary gland. It is unique among hormones in that it responds to inhibition by the hypothalamus rather than to stimulation. The only known function of prolactin is to induce milk production in female breasts that are already stimulated by high estrogen levels. When milk production is established lactation can continue without elevated prolactin levels. Prolactin rises in late pregnancy, peaking with the initiation of lactation and surge each time a women breast feeds.
Indications for testing:
- Assist in the diagnosis of primary hypothyroidism, as indicated by increased levels.
- Assist in diagnosis of suspected tumor involving the lungs of kidneys elevated levels indicating ectopic prolactin production_)
- Evaluate failure of lactation in the post partum period
- Evaluate sexual dysfunction of unknown cause in men and women.
- Evaluate suspected postpartum hypophseal infarction as indicated by decreased levels.
Progesterone– is a female sex hormone. Its function is to prepare the uterus for pregnancy and the breasts for lactation. Progesterone testing can be used to confirm that ovulation has occurred and to assess the functioning of the corpus luteum. Serial measurements can be performed to help determine the day of ovulation.
Indications:
- Assist in the diagnosis of luteal phase defects.
- Evaluate patients at risk for early or spontaneous abortion.
- Identify patients at risk for ectopic pregnancy and assessment of the corpus luteum.
- Monitor patient ovulating during the induction of Human chorionic gonadotropin HCG), human menopausal gonadotropin, follicle stimulating hormone or clomiphene.
- Monitor patients receiving progesterone replacement therapy. 1
Ovulation Problems: Two hormones, luteinizing hormone or LH and follicle-stimulating hormone or FSH, control your ovulation. If low levels of these hormones are being produced, you could have irregular or even no ovulation. The good news about ovulation problems is that they can often be corrected naturally through diet and balancing herbs. Excessive exercise and too little fat in your diet can both be culprits in anovulation (not ovulating) and irregular ovulation.
Polycystic ovarian syndrome (PCOS) is an endocrinologic disorder that can appear in women of reproductive age. It is the leading cause of fertility and affects 6-10% of women of childbearing age. It was not described until 1935 by Stein and Leventhal. PCOS can also be referred to as Stein-Levanthal syndrome. It is referred to as a syndrome because it contains many symptoms. These symptoms include obesity, hirsutism, acne, infrequent or abnormal ovulation, amenorrhea, oligominorrhea, hyperandrongenism, an elevated utilizing hormone to follicle stimulating hormone ratio, chronic pelvic pain, insulin resistance, hyperinsulinemia, type II diabetes, dyslipidemia, and hypertension. These symptoms can get worse with weight gain. The onset of the disease can be as early as puberty, but usually begins in adolescence. The cause of PCOS is unknown. Some literature suggest it is genetic with autonomic dominant mode of transmission. can get worse with weight gain. The onset of the disease can be as early as puberty, but usually begins in adolescence. The cause of PCOS is unknown. Some literature suggests it is genetic with autonomic dominant mode of transmission.5.
Hirsutism
Hirsutism is a condition where women have excess facial and body hair that is dark and coarse. The abnormal hair growth usually happens on the body where men typically grow hair, on the chest, face, and back.
Some body and facial hair is normal, and the amount varies among women. But about half of women with hirsutism may have high levels of male sex hormones called androgens. Most cases of hirsutism are not severe and have no underlying cause. An estimated 8% of adult women in the United States have hirsutism. Sometimes there is no cause that can be identified.
Signs and Symptoms:
The top symptom of hirsutism is hair growth on the abdomen, breasts, and upper lip (male-pattern hair growth in women). If hirsutism is caused by high levels of male hormones, symptoms also can include:
- Irregular menstrual periods
- Acne
- Loss of feminine body shape
- Signs of masculinity — deepening voice, male pattern baldness, enlarged clitoris, enlarged shoulder muscles
About half of women with hirsutism have high levels of male sex hormones, called androgens. High levels of these hormones can be caused by:
- Polycystic ovarian syndrome (PCOS) — may also cause infertility
- Tumors on the adrenal glands or ovaries
- Cushing syndrome
- Medications that can cause hair growth — phenytoin, minoxidil, diazoxide, cyclosporine, and hexachlorobenzene
- Anabolic steroids
- Danazol — used to treat endometriosis4. (more information)
References:
1. Van Leeuwen, Anne M, Poelhuis-Leth, Debra J.Daivs Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications. (2009) Third edition. pgs 628-629, 814-815, 990-992, 988-989
2. http://www.getting-pregnant.com/causes-of-infertility.html.
4. http://www.umm.edu/altmed/articles/hirsutism-000081.htm
5. http://www.soulcysters.net/showthread.php?63353-Nutrition-Intervention-for-Polycystic-Ovarian-Syndrome
