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Natural Awakenings Metro Phoenix & Northern Arizona

Maximize Your Fertility Hormone Balance: There can be many factors behind fertility problems, says Dr. Marianne Marchese

Apr 30, 2014 10:11AM ● By By Dr. Marianne Marchese

Trouble conceiving can put strain on a relationship and become the source of heartache, stress and unexpected medical expense. Infertility is a rising problem. It is estimated that greater than one in six couples in the U.S. have impaired fertility. Problems can be linked to men’s hormones and sperm abnormalities, as well as female health concerns. Couples should start early to maximize their fertility by seeing a doctor and evaluating hormones, checking for systemic conditions such as hypothyroidism and screening for exposure to environmental chemicals. Stress management is important for both men and women, because stress has a negative effect on hormones and fertility.

Many factors account for fertility problems in couples; 35 to 40 percent are due to male factor problems, 35 to 40 percent are due to female factors and 20 to 30 percent are due to a combination of male and female factors. Some problems with fertility are unexplained.


Pelvic factors include infection: pelvic inflammatory disease, STIs, endometritis; prior surgery: D&C, appendicitis, fibroids, endometriosis, adnexal surgery; contraception and pregnancy history: hormones, DES exposure, miscarriage; and menstrual cycle issues: metorrhagia, menorrhagia, endometriosis, pelvic pain.

Ovulatory factors include secondary amenorrhea; abnormal uterine bleeding; luteal phase defect; premature ovarian failure; polycystic ovarian syndrome; elevated prolactin; hypothyroidism; and prior use of anti-estrogens (Lupron, Depo-Provera).

Systemic factors include delayed childbearing; overweight or underweight; insulin resistance; kidney and liver disease; substance use (alcohol, marijuana, caffeine, tobacco); and malabsorption (celiac, IBD).

Unexplained factors include environmental chemicals.


Factors include low testosterone; low sperm count; primary hypogonadism; androgen insensitivity; cryptorchidism; medications; orchitis, including mumps orchitis; systemic disorder; thyroid disorder; testicular trauma/radiation; varicocele; chromosome defect; altered sperm transport; absent vas deferens or obstruction; epididymal absence or obstruction; erectile dysfunction; secondary hypogonadism; androgen excess state; and unexplained.

Environmental factors account for most unexplained infertility and many of the health conditions listed above, including PCOS, endometriosis and hypthyroidism. Women and men are exposed to chemicals through food, water, air, cosmetics, lotions, plastic bottles and food storage containers. The most common chemicals linked to fertility problems in both men and women include cigarette smoke, pesticides, polychlorinated biphenols (PCB), perfluorooctane sulfonate (PFO) and perfluorooctanoate (PFOA), fish consumption and mercury, bisphenol-a (BPA) and phthalates.

Daily low-dose exposure to chemicals can build up in the body over a few days, weeks, months and years. Not only do these chemicals affect men and women’s fertility, but if a couple conceives, these chemicals are passed in utero to the fetus, which studies have linked to autism, ADD, hyperactivity, cognitive and behavior problems.

A couple should start preparing for pregnancy at least one year before beginning to conceive. Preconceptive counseling includes education on how to avoid hormone disrupting chemicals. Both men and women should complete an eight-week detoxification plan to remove chemicals from the body to balance hormones and minimize exposure to the fetus.

There are many naturopathic treatment options available to maximize fertility and treat both male and female factor infertility. Botanical medicine, amino acids, vitamins, minerals and homeopathy can improve all factors of fertility. Stress management, detoxification, exercise, lifestyle changes and nutrition should be incorporated into a plan, as well. It’s never too early or too late to incorporate naturopathic medicine into our life and balance our hormones.

Dr. Marianne Marchese, author of 8 Weeks to Women’s Wellness, maintains a private practice in Phoenix and teaches gynecology at Southwest College of Naturopathic Medicine. She was named Phoenix magazine’s Top Doctor in Naturopathic Medicine for 2014. For more information, visit

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