Signs and Symptoms of Infertility in Women

Overview

Infertility happens when a couple cannot conceive after having regular unprotected sex for atleast 12 months.

Men and women are equally likely to have fertility problems. In general:

• In about one-third of cases, there is an issue with the man
• In about one-third of cases, there is an issue with the woman
• In the remaining cases, there are issues with both the man and the woman, or no cause can be found

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control.

Secondary infertility is when they have previously conceived but are no longer able to.

What are the main causes of infertility in women?

• Age: The ability to conceive starts to fall around the age of 32 years.
• Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus preventing sperm from fertilizing the egg.
• Endometriosis: A condition in which the type of tissue that forms the lining of the uterus is found outside the uterus. Inflammation from endometriosis may damage the sperm or egg or interfere with their movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes may be blocked by adhesions or scar tissue.
• Tubal Infection: Also known as Fallopian Tube Infection, is caused by unwarranted and excessive growth of malignant bacteria in the fallopian tubes. Some of the bacteria causing the tubal infection include Streptococcus, Mycoplasma, and Staphylococcus. The disease can also be caused by sexually transmitted diseases (STDs) e.g. Chlamydia, Gonorrhea, etc.
• Radiation therapy: It can increase the risk of fertility problems.
• Autoimmune disorders: Autoimmune disorders cause the body’s immune system to attack normal body tissues that it would normally ignore. Autoimmune disorders, such as lupus, Hashimoto’s and other types of thyroiditis, or rheumatoid arthritis, may affect fertility.

What are the common signs of infertility in women?

• Irregular menstrual periods is a strong signifier of problems with fertility levels.
• Painful or heavy menstruation can be a symptom of endometriosis. The condition can lead to painful inflammation and scarring, which can cause fertility problems by impeding pregnancy.
• No periods can be a sign of fertility issues.
• Skin irritations can be a sign of problems with fertility levels.
• Reduced sex drive
• Facial hair growth
• Thinning hair
• Excessive weight gain
• Smoking: Smoking significantly increases the risk of infertility in both men and women. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
• Alcohol consumption: It can affect the chances of conceiving.
• Obesity: It may reduce the chances of conceiving.
• Diet: A lack of folic acid, iron, zinc, and vitamin B-12 in the diet can affect fertility.
• Mental stress: This may affect female ovulation and can lead to reduced sexual activity.
• Ovulation disorders are the most common cause of infertility in women and can be due to:
  • Polycystic ovary syndrome (PCOS): A condition that causes women to not ovulate, or ovulate irregularly.
  • Diminished ovarian reserve (DOR): A condition in which fewer eggs are remaining in the ovaries than normal. The number of eggs a woman has declines naturally as a woman ages.
  • Functional hypothalamic amenorrhea (FHA): A condition when the menstrual cycle and ovulation are disrupted due to the hypothalamus not working properly.
  • Primary ovarian insufficiency (POI): A condition sometimes referred to as premature menopause, occurs when a woman’s ovaries fail before she is 40 years of age.
  • Menopause: An age-appropriate decline in ovarian function that usually occurs around age 50. By definition, a woman in menopause has not had a period in one year.
  • Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy.
  • Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.

• Pain during sex can be caused by hormonal issues such as endometriosis, or other underlying conditions such as sexually transmitted infections which could also be contributing to infertility.

What are the risk factors linked to Infertility?

• Age: Women’s fertility gradually declines with age.
• Tobacco use: Smoking may reduce the likelihood of pregnancy. Miscarriages are more frequent in women who smoke.
• Alcohol: Alcohol use may contribute to infertility.
• Obesity: An inactive lifestyle and being overweight may increase the risk of infertility.
• Mental Health: Depression and stress can affect the hormones that regulate the reproductive cycle. Women dealing with these issues may not ovulate normally.

Tips for improving fertility?

• Maintain a healthy weight and eat a healthy, well-balanced diet.
• Avoid illicit drugs and tobacco.
• Consume alcohol in moderation or avoid it entirely.
• Get regular exercise at a moderate level of intensity.
• Avoid exposure to industrial or environmental toxins.
• Avoid medicines that may affect fertility.