A few years ago, Rachel and her husband started trying to have kids. As a first step, Rachel stopped taking birth control. Her at-home pregnancy tests kept telling her she wasn’t pregnant, but she wasn’t having a period. Not sure what was going on, but hearing alarm bells, she saw a reproductive endocrinologist - a specialist focused on the hormones that impact fertility and the reproductive system. It turns out that she wasn’t actually ovulating with her period. Blood testing and a pelvic ultrasound diagnosed her with Polycystic Ovary Syndrome (PCOS) and high glucose. Her high glucose results confirmed that she had type 2 diabetes. The information her period gave her by being irregular allowed her to reassess her health as a whole, ultimately saving her from further health complications down the line.
No matter how you feel about having children, or where you are on your journey to being––or not being––a parent, understanding your fertility is important for your health. Clues from your hormones, your menstrual cycle, and your reproductive organs can help you understand your body and your overall well being. Having as much information as possible can help you see the big picture - and help you make decisions that are right for you, your health, and your body.
When learning about your fertility, you’ll probably start hearing about your FSH. FSH stands for follicle-stimulating hormone, which is responsible for the growth of ovarian follicles (the cellular structures that house your eggs). These follicles produce both estrogen and progesterone (along other hormones) in the ovaries and control aspects of your menstrual cycle. Checking your FSH levels (for an FSH test, blood is drawn) will provide you with information about your fertility - and also let you know what’s going on with your pituitary gland.
From its captain’s seat at the base of your brain, the pituitary gland controls the functions of other glands in your body, while producing hormones that impact growth. Because of this, it’s often known as the "master control gland." Your FSH levels give you and your doctors information about any pituitary disorders or hormone imbalances you might have. Quite a few things can impact your hormones and your FSH levels––for instance, stress and being severely underweight. If you’re experiencing hot flashes, night sweats, extreme mood swings, or difficulty sleeping at night, you might be looking at a hormonal imbalance, such as changes in your progesterone levels, as well as those of LH, oxytocin, testosterone, thyroid, cortisol, leptin, or estrogen. Visit your health care provider for a physical exam and blood tests that can help assess what's going on. (Modern Fertility's kit also measures most of these hormones, and you can test at home).
Your thyroid can also have an impact on your fertility and testing for thyroid diseases can give you a better idea about your overall health. Your thyroid gland has a say in almost all of the metabolic processes in your body. Thyroid disorders come in many shapes and sizes, they can range from an enlarged gland that needs no treatment to cancer. High levels of the thyroid hormone T4 result in hyperthyroidism. On the flipside, hypothyroidism, a disorder of your pituitary gland, occurs when you’re lacking in T4. Hypothyroidism can present itself with a wide variety of symptoms, some of which even resemble early signs of pregnancy. These symptoms include fatigue, weaknesses, weight gain or difficulty losing weight, hair loss, constipation, memory loss, and even irritability. With hypothyroidism, you might also notice an irregular period and you may not be ovulating - an occurrence known as an anovulatory cycle. During an anovulatory cycle, you might experience an insufficient level of progesterone, causing heavy bleeding but no actual ovulation. Hormone replacement therapy can be used when anovulatory cycles occur. Studies estimate that around 27 million Americans have a thyroid imbalance, meaning at least 10% of people with a uterus may have some degree of thyroid hormone deficiency.
Changes in your menstrual cycle or flow can also indicate health issues. Paying attention to these changes can clue you to something being wrong. Your cycle may not be 30 days (or 28 days), but there should be some pattern to it. If you start to see your period arriving at unexpected times (or not arriving at all), that might be an indication of medical issues. An irregular period might be a warning sign for PCOS. Menorrhagia, a heavy flow, that lasts longer than a week can be a symptom of PCOS, as can excess hair growth on one's face, chest, and back. In addition to possible fertility complications, PCOS can increase your risk of heart disease, diabetes and endometrial cancer.
Your period can offer other indications as to the state of your health. If you notice spotting in between your periods, don’t panic. It might mean nothing - or, it could point towards a yeast infection or an STI. Spotting could also be a sign of uterine cancer or cervical cancer. While you’re paying attention to your period, be sure to note the color and smell. Be on the lookout for any changes. Your period normally has a smell attached to it, but a stronger odor than usual, especially one with an overwhelming fish-like smell, or watery menstrual blood could be a sign of an infection.
Cramps are normal, but can also be a sign that something new is going on in your body. Your cramps shouldn’t be excruciating; if you find yourself unable to find relief from over the counter pain medications and a hot water bottle, you might be dealing with something serious, such as endometriosis. If you are feeling cramps when you’re not bleeding or in the middle of your cycle, that can also indicate ovarian cysts. Ovarian cysts are fluid-filled sacs or pockets that develop on the surface or inside of your ovary. While it’s not uncommon to have cysts, cysts that rupture can cause serious pain. Cysts that develop after menopause can also be cancerous.
The bottom line: being fertile doesn’t necessarily mean you’re healthy. That being said, understanding your fertility can be one more tool in understanding your health and your body. Even if you’re not planning on having children, it's always a good idea to get a handle on your reproductive health. If you are planning on trying soon, Modern Fertility can help you find more answers about your hormone levels, and even your ovarian reserve. Each piece of the health puzzle can help you live a healthier life.