Common Causes of Infertility

Did you know that estrogen dominance is one of the most common causes women struggle with infertility? When excess estrogen dominates, it overloads the estrogen receptors (ER-α and ER-β) and causes other hormonal imbalances, it leads to damaging tissue, blood vessels, and accelerating diseases such as autoimmune disorders, heart disease, stroke, and cancer. 

Because estrogen dominance disrupts the flow of reproductive endocrine hormones and causes progesterone levels to drop down to miniscule levels, it has caused exacerbant spikes in gynecological disorders such as polycystic ovary syndrome, breast, uterine, and ovarian cancer, enlarged breasts, and infertility to name just a few (Patel et al., 2018). These problems are becoming widespread both in the U.S. and worldwide. 

To remedy this, we want to shift the hormonal balance by decreasing estrogen level and/or increasing progesterone. Some integrative approaches for decreasing estrogen dominance include: 

Remove estrogen mimickers

Foods commonly consumed in the U.S. and in most wealthy nations include meat, eggs, and dairy products. They unfortunately carry high concentrations of xenoestrogens since they are derived from animals which also produce estrogen naturally. When animal proteins are consumed by humans, they tend to mimic natural estrogen. The problem is with regular consumption of dairy products, eggs, and/or meat (i.e., poultry, red meat, fish), the liver cannot keep up with such high levels of estrogen and hence, cause estrogen overload. 

Parabens commonly found in most commercial cleaning and beauty products, plastics loaded with BPA and phthalates often found in most packaged food and beverage packaging, and tampons also carry high concentrations of xenoestrogens.  Because these items are heavily consumed and utilized by most Americans in their daily lives and caused many unfriendly reactions within the body, it has unfortunately led to infertility rates now skyrocketing and noticeable by age 23 to 25 in both men and women. 

If you are struggling with infertility and other gynecological disorders, it may be best to decrease and/or avoid all forms of animal protein such as dairy products, eggs, red meat, poultry, and fish. Try to stick to having fresh organic plant-based foods not packaged in plastic and utilizing plastic containers for food storage whenever possible. This will help decrease your exposure to pesticides which directly damage your reproductive organs and liver, drive up excess estrogen levels in the blood, and accelerate infertility for both men and women.  

Increase intake of cruciferous vegetables.

Cruciferous vegetables such as kale, broccoli, cabbage are rich sources of glucosinolates whose hydrolytic products, primarily isothiocyanates (ITCs) and indoles (e.g. Indole-3-carbinol, I3C) have been found to prevent and possibly even inhibit breast cancer growth. By modulating the activity of phase I and phase II enzymes in the liver and jumpstart detoxification, glucosinolates inhibit abnormal cancer cell growth, alter the metabolism of estrogen and regulate its receptors’ expression, and suppress byproducts (i.e., Cyclooxygenase 2 (COX-2) produced from inflammatory cells (Lin et al., 21017).

Cruciferous vegetables also contain diindolylmethane (DIM),  a byproduct of I3C. Some studies have demonstrated that DIM enhances the breakdown of estrogen and “can potentially serve as an antiestrogenic dietary supplement” (Rajoria et al., 2011). 

In order to easily metabolize cruciferous vegetables and gain the most value, drink a few cups of water over a half hour or more beforehand and try not to drink any liquids while having the meal. This will drastically help increase the absorption of fiber from cruciferous vegetables along with better regulate bowel movements, and accelerate elimination of excess estrogen. 

Excessive estrogen slows down how fast digested food moves through the GI tract and often leads to sluggish digestion, poor absorption of critical nutrients, vitamins, minerals and proteins from food, and more easily triggers constipation.  This directly leads to increased reabsorption of estrogen consumed in one’s diet and hence, causes excess estrogen dominance. Although taking digestive enzymes, increased water hydration, and juicing can help lessen constipation, it doesn’t always fully prevent reabsorption of estrogen. It is critical for the liver to be able to properly detoxify and eliminate estrogen; otherwise, studies have shown high levels of estrogen dominance remain in the stomach and small intestinal mucosa (Oh et al., 2013). 

Seed cycling

Seed cycling recommends a woman consume specific seeds every day for a few months in order to promote hormone rebalancing during different stages of her menstrual cycle. During the follicular phase on days 1 to 14 of the menstrual cycle equivalent to the onset of menses to ovulation, eat 1 tablespoon each of pumpkin and flax seeds in order to increase healthy estrogen levels. Flax seeds are high in lignans, which are structurally similar to estradiol (E2) – the most potent form of estrogen. Conversely, during the luteal phase on days 14 to 28 of the menstrual cycle equivalent to the period between ovulation and the next menstrual cycle, eat 1 tablespoon of sunflower and sesame seeds to enhance progesterone production and counteract estrogen dominance. 

Calcium-D-glucarate 

Calcium-D-glucarate, also known as glucaric acid, is naturally found in many fruits and vegetables with the highest concentration found in oranges, apples, grapefruit, and cruciferous vegetables. Studies have shown that oral supplementation of calcium-D-glucarate can inhibit beta-glucuronidase, an enzyme made by gut bacteria, which  deconjugates estrogens into its active unbound forms during Phase II liver detoxification and allows estrogen to recirculate through the body. Clinical applications of oral calcium-D-glucarate may theoretically help regulate estrogen metabolism and act as a lipid-lowering agent (Calcium-D-glucarate, 2002). Realistically, it is best to just eat green vegetables (cooked versus raw preferred) as a main source of Calcium-D-glucarate by incorporating it into your daily diet and complimenting with a small piece of fruit as your main dessert (not sugar). 

Vitex Agnus-Castus

Vitex Agnus-Castus, also known as chasteberry, is a modulator between the hypothalamus and pituitary glands in the brain and the ovaries. Clinical studies have shown that vitex has progestogenic activity which can lead to increased progesterone levels while reducing estrogen dominance (Vitex Agnus-Castus - an Overview | ScienceDirect Topics, n.d.).

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References:

Calcium-D-glucarate. (2002). Alternative medicine review : a journal of clinical therapeutic, 7(4), 336–339.

Lin, T., Zirpoli, G. R., McCann, S. E., Moysich, K. B., Ambrosone, C. B., & Tang, L. (2017). Trends in Cruciferous Vegetable Consumption and Associations with Breast Cancer Risk: A Case-Control Study. Current developments in nutrition, 1(8), e000448. https://doi.org/10.3945/cdn.117.000448

Oh, J.-E., Kim, Y.-W., Park, S.-Y., & Kim, J.-Y. (2013). Estrogen Rather Than Progesterone Cause Constipation in Both Female and Male Mice. The Korean Journal of Physiology & Pharmacology : Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology, 17(5), 423–426. https://doi.org/10.4196/kjpp.2013.17.5.423

Patel, S., Homaei, A., Raju, A. B., & Meher, B. R. (2018). Estrogen: The necessary evil for human health and ways to tame it. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 102, 403–411. https://doi.org/10.1016/j.biopha.2018.03.078

Rajoria, S., Suriano, R., Parmar, P. S., Wilson, Y. L., Megwalu, U., Moscatello, A., Bradlow, H. L., Sepkovic, D. W., Geliebter, J., Schantz, S. P., & Tiwari, R. K. (2011). 3,3'-diindolylmethane modulates estrogen metabolism in patients with thyroid proliferative disease: a pilot study. Thyroid : official journal of the American Thyroid Association, 21(3), 299–304. https://doi.org/10.1089/thy.2010.024

Vitex Agnus-Castus—An overview | ScienceDirect Topics. (n.d.). Retrieved February 17, 2021, from https://www.sciencedirect.com/topics/medicine-and-dentistry/vitex-agnus-castus

AUTHOR

Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of SF Advanced Health. She combines the best in Eastern and Western Medicine to understand the root causes of diseases and provide patients with personalized treatment plans that quickly deliver effective results. Dr. Bhandari specializes in cell function to understand how the whole body works. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.