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5 health conditions that can affect female fertility

We look at the conditions that can affect female fertility.

Polycystic ovary syndrome (PCOS) 

PCOS is a common health condition experienced by 1 in 10 women in the UK [1]. Women with PCOS have a large number of harmless fluid-filled sacs (follicles) within their ovaries. This means that the ovaries cannot release an egg as frequently (you ovulate less), and the growth of follicles in the ovaries can cause hormonal changes in the body, such as an excess of male hormones (androgens). 

PCOS can mean that women experience symptoms, such as: 

  • Irregular periods or no periods at all 
  • Excessive hair growth on the body 
  • Weight gain or difficulty losing weight. 
  • Thinning hair or hair loss from the head 
  • Oily skin or acne 

Although many women with PCOS do achieve successful pregnancy women should know that a PCOS diagnosis can reduce their fertility. Ovulation may not occur every month, and sometimes ovulation does not occur at all; this means fewer eggs are available to be fertilised. 

More than half of the women who have PCOS do not experience symptoms at all, and many only discover they have PCOS when trying to get pregnant and are unsuccessful [1]. 

A PCOS diagnosis usually focuses on scans showing you have polycystic ovaries, symptoms like irregular or absent periods, and the existence of high levels of male hormones (androgens) in the body, which are usually uncovered through blood tests [1]. 

 If you are experiencing fertility problems or symptoms associated with high levels of male hormones, and you want to investigate the presence of PCOS, Medichecks offer a simple finger-prick Polycystic Ovary Syndrome Blood Test, which you can take in the comfort of your own home. This test measures the level of hormones in your body. It can therefore indicate if your hormone levels are higher than they should be. You may also want to try our Advanced Polycystic Ovary Syndrome Blood Test, which includes a more significant number of hormonal biomarkers along with cholesterol, which can commonly be higher than normal in PCOS. 

Endometriosis 

Endometriosis is a condition that affects around 1 in 10 women of reproductive age [2]. It occurs when tissue that is similar to the womb lining begins to grow in other areas of the body. This can react to the menstrual cycle, causing inflammation, pain, and scar tissue formation.  

Symptoms of endometriosis include: 

  • Heavy periods which are difficult to control using pads and tampons 
  • Pain in lower abdomen which can worsen during your period 
  • Pain in other areas of the body such as back and legs which can worsen during your period 
  • Pain during or after sex 
  • Pain when peeing or pooing 
  • Feeling sick, constipated or having diarrhoea 
  • Bleeding in between periods or when you pee 

Endometriosis can also affect fertility so some women with endometriosis can face difficulty in getting pregnant. This thought to occur because the tissue can grow near your fallopian tubes or ovaries, affecting ovulation. It is important to remember that even with severe endometriosis, natural conception is still possible [3]. 

On average, it takes 7.5 years from the onset of symptoms to get a diagnosis [2]. Endometriosis is difficult to diagnose because the symptoms can vary considerably. Sometimes, a doctor may refer a patient to a specialist for tests such as an ultrasound scan or laparoscopy (the specialist will pass a small camera through a cut in your abdomen). 

If you are experiencing symptoms of endometriosis, you should visit your GP, especially if it significantly impacts your life. Endometriosis UK offers a pain and symptom diary that can help you track your symptoms and help your GP to assess the symptoms you experience. Although there is no direct cure for endometriosis, there are many treatments available to improve your quality of life. Read more about treatments for endometriosis here. 

Hypothyroidism 

Hypothyroidism is a health condition which is caused by an underactive thyroid (a small butterfly-shaped gland in the neck). An underactive thyroid does not produce enough of the thyroid hormones T4 and T3, which are used throughout the body to regulate metabolism. 

This condition can affect both men and women, but it is more commonly experienced in women [4].   

Symptoms of hypothyroidism include: 

  • Tiredness 
  • Weight gain 
  • Depression 
  • Sensitivity to the cold 
  • Dry skin and hair 
  • Muscle aches [4] 

An underactive thyroid can slow down ever function in your body, from your heartbeat and muscles to your digestive functions. Unfortunately, an underactive thyroid also leads to reduced production of gametes (eggs and/or sperm). In women, it can cause longer and heavier periods. Sometimes periods may stop altogether. All of these factors, along with a reduction in libido (sex drive) that is common in hypothyroidism, means it is more difficult to conceive with hypothyroidism. 

Medichecks offer a Thyroid Function Blood Test, which measures important hormones essential for thyroid health. They can tell you whether your thyroid is working normally. 

The reassuring thing is that once you are taking medication and your thyroid hormone levels have returned to normal, your chances of conceiving can improve dramatically [5]. 

Sexually transmitted infections (STIs) 

Sexually transmitted infections (STIs) are common, and unfortunately, they do not always cause symptoms. Some STIs such as chlamydia, gonorrhoea and syphilis can cause fertility problems in women [6]. Here’s how: 

Chlamydia: If left untreated, the infection can travel to the womb, fallopian tubes and ovaries and lead to the development of scar tissue which can affect ovulationblock the fallopian tubes, and prevent eggs travelling from the ovary to the womb. Encouragingly, if chlamydia is detected, it can be treated very simply with antibiotics. 

Gonorrhoea: If left untreated, gonorrhoea can head to a condition called pelvic inflammatory disease (PID). Symptoms of PID include lower abdominal pain and heavy and painful periods. The risk of infertility will increase with each bout of inflammation. If you suspect you may be infected, it is crucial to get checked out. 

Syphilis: can result in health problems for a child at birth and in later life. Syphilis can also cause miscarriage and stillbirth [6]. 

It is essential to catch STIs early to prevent the infection from progressing into more severe problems. Many STIs don’t cause severe symptoms, so experts recommend testing to find out whether you have an infection. Medichecks offer an at-home and discrete 6-in-1 STI Blood and Urine Test for the most common sexually transmitted infections (STIs), which includes chlamydia along with HIV, gonorrhoea and syphilis. 

Premature ovarian insufficiency (POI) 

Premature ovarian insufficiency (POI) is a condition that affects 1 in every 100 women under the age of 40 [7]. It is caused by the ovaries not functioning normally. They stop producing eggs years, and in some cases, even decades before they should [7]. This means that you will not ovulate as frequently or regularly, and in some cases, not at all. Not only does this cause a decline in fertility, but it can cause hormonal changes which affect the body. 

Due to the hormonal changes which occur, POI can cause symptoms that are similar to menopause, such as: 

  • Hot flushes and night sweats 
  • Skin and hair changes (dryness, thinning) 
  • Weight gain (especially around the waist) 
  • Mood swings and irritability 
  • Fatigue and low energy levels 
  • Vaginal dryness [8]. 

If you think you may be experiencing POI, Medichecks offer a Future Fertility Blood Test which measures hormones which can change in POI, such as follicle stimulating hormone (FSH) and anti-mullerian hormone (AMH). This blood test is a first step into investigating your symptoms. Our expert doctors will comment on your results and help you understand whether your ovarian function is normal or whether you might be experiencing POI. 

A diagnosis of POI can be distressing for women who are having difficulty getting pregnant. Talk to your fertility advisor about what options are open to you. If you are experiencing POI, there are places you can seek help and support. Speaking to other women who are experiencing the same challenges may help you to feel understood. Daisy network is an excellent support group for women with premature ovarian insufficiency and can offer great advice. 

References 

[1] https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ 

[2] https://endometriosis-uk.org/endometriosis-facts-and-figures 

[3] https://endometriosis-uk.org/endometriosis-fertility-and-pregnancy 

[4] https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/ 

[5] https://www.btf-thyroid.org/pregnancy-and-fertility-in-thyroid-disorders 

[6] https://www.yourfertility.org.au/everyone/health-medical/sexually-transmitted-infections-stis 

[7] https://www.daisynetwork.org/about-poi/what-is-poi/ 

[8] https://www.daisynetwork.org/about-poi/signs-and-symptoms/