Women's reproductive health issues are on a steady incline. The CDC reports that 10% of women ages 15-44 have difficulty conceiving. The causes vary from lifestyle, dietary involvement, genetics, and environment to common reproductive health conditions. While contributing factors may change your trajectory to motherhood, there are many integrative and holistic approaches you can take to optimize fertility. Evaluating the areas of your life that may be impacting your reproductive health is a good starting place.
What is Reproductive Health?
Males and females both have reproductive systems that change and influence our overall health. For women, this includes the organs that produce hormones and are involved in reproductive processes. These systems' essential functions allow for stages of reproductive development like puberty, sexual activity, fertility, pregnancy, and menopause. Reproductive health also includes accessibility to care, preservation of women's bodily autonomy, and reproductive health equality.
What Causes Reproductive Health Issues?
There are many factors that can contribute to reproductive health issues in women. Some of the most common causes include:
According to research, women have been losing sleep at an average rate of three hours less per night. The average amount of sleep per night for women is 6.8 hours compared to the nine hours it was a century ago. Although there are limited clinical trials on what lack of sleep does to reproductive health, we do know that hormone synthesis and circadian rhythms require sleep and restoration for optimal functioning. One area of concern is amongst women who do shift work. A study looked at females who worked ten to twelve-hour shifts starting around 8 pm. What was revealed in these workers compared to non-shift workers was an increase in menstrual disruption and infertility. Another study on the topic (in the same review) reported an increase in first-trimester miscarriages among female flight attendants that were working during their normal sleep periods.
Movement is vital for all areas of health, including reproductive function. Engaging in physical activity helps maintain a healthy weight, improve mood, decrease inflammation, and regulate hormones. A meta-analysis validated that physical activity improves pregnancy rates and is potentially as effective as other medical interventions aimed at improving fertility. On the flip side, too much rigorous exercise can lead to depletion, which has a negative implication for reproductive health. Clinically speaking, excess exercise routines can lead to menstrual irregularities, hormonal acne, and nutrient depletion.
Promiscuous and unsafe sex can increase your risk of contracting a sexually transmitted disease. STDs such as Chlamydia trachomatis and Neisseria gonorrhea are pathogenic bacteria that are known contributors to infertility and conditions such as Pelvic Inflammatory Disease.
Being overweight or underweight both have implications for reproductive health. When it comes to conception, being overweight can prevent ovulation due to estrogen release from fat cells. It can also impact IVF treatments, be a double-edged sword in those with PCOS and impact your menstrual cycle. On the other hand, being too underweight can lead to decreased estrogen production, which is needed in an optimal menstrual cycle. Low estrogen can decrease ovulation, leading to infertility.
Smoking, Drinking, and Drugs
All three of these lifestyle choices have detrimental effects on fertility and reproductive organ health. Smoking cigarettes can decrease egg count by aging a women's ovaries. Chronic and even occasional consumption of alcohol can increase ovulation disorders and menstrual disturbances. While we know using these recreational substances during pregnancy is detrimental to fetal development, there is limited and conflicting human evidence on reproductive health and drug use. A general scientific consensus is that women who engage in illicit drug use have more hormonal issues across the spectrum, ranging from menstrual irregularities to pregnancy, breastfeeding, and menopausal complications.
Across all life stages of a female's reproductive health, diet and nutrition directly impact organ function and biochemical processes. One prime example is the need for adequate macronutrient consumption for proper ovulation. Malnutrition, especially in cases of anorexia nervosa and bulimia, is known to stop menses from happening, induce infertility, and increases the chances of miscarriage. Depending on the stage of life you are in, your body requires different amounts of caloric intake, vitamins, minerals, and macronutrients to sustain proper reproductive health.
This area of research is continually evolving to determine the causes of infertility, the risk for reproductive organ pathologies, and to determine the odds of passing on inheritable conditions. Genetic testing to investigate the cause of infertility takes place in about 35% of couples who cannot get pregnant after 12 months of trying. While it has been reported that around half of infertility cases are related to genetic conditions, many infertile couples remain undiagnosed due to standard testing procedures and a lack of individuality. As this field continues to grow into genome-wide studies like this one, we’ll be able to pinpoint more accurate causes of genetically linked infertility.
Exposure to heavy metals, DES, and other endocrine-disrupting chemicals have detrimental effects on reproductive health. Environmental exposure is a leading concern from an epigenetic perspective in how these constant encounters in our environment impact all health areas, including reproductive health. A small study from 2005 done by the Environmental Working Group found astonishing results from newborn umbilical cord blood. An average of 200 industrial chemicals and pollutants were detected when tested for environmental toxins. This has provided insight into the severity of transmission from mother to fetus during development. A main concern, which has been identified in other environmental toxicity research, is that these chemicals do not simply leave the body and can have lasting negative implications.
Functional Medicine Labs For Women’s Reproductive Health
Functional Medicine labs help practitioners get to the root cause of women's reproductive health issues. Here are some of the most common tests run:
Melatonin is a hormone that directly impacts our circadian rhythm. Evaluating sleep quality in women who work nightshift or have chronic sleep deprivation can be insightful. Doctor's Data offers a salivary Melatonin Test that looks at morning, evening, and nighttime levels. This profile test depicts sleep/wake cycle patterns throughout one day. Having this information can be valuable in lifestyle modification and treatment options.
The Hormone Panel by Vibrant America looks at 13 sex hormones and metabolites such as cortisol. This is a great baseline hormone test to determine if there are any stark hormone imbalances contributing to your reproductive issues.
When the body is under physiological stress from factors such as lack of sleep, dietary deficiencies, or environmental exposures, it can cause inflammation in the body. Two helpful markers to run are hs-CRP and ESR, which can provide insight into whether inflammation is playing a role.
Testing for heavy metals, chemicals, and other pollutants is of increasing concern regarding endocrine disruption. Toxins create a total body burden that affects our reproductive organs and functions. Investigating environmental toxicity through an Environmental Pollutants Profile test can provide context to exposures that are impacting your reproductive health.
Other than MTHFR testing, a genetic counselor should conduct all genetic testing regarding reproductive health. They will be able to guide you in proper testing and be a great resource in processing any hard-to-navigate results. SpectraCell Laboratories is one of many labs that offer an MTHFR Genotyping test to rule out any polymorphism that can impact reproductive health.
Contracting a sexually transmitted disease can impact your reproductive well-being. If you feel like you have been exposed, or you are experiencing symptoms of an STD, it is advised to have a pelvic exam and appropriate testing done. While a pap smear is the most common route, Access Medical Laboratories offer a blood sample STD Panel which tests for nine sexually transmitted pathogens.
How to Improve Women's Reproductive Health Based on Lab Testing Results
Based off lab results, functional medicine practitioners are able to individualize protocols. Below are some of the most common functional medicine treatment options:
Exercise for Women's Reproductive Health
Movement provides an abundance of therapeutic value. Regarding reproductive health, you want to follow the "Goldie Locks Rule"- Not too much, not too little, but just enough! Finding the right balance that best supports hormone health and weight management and does not induce stress is key. A systematic review of studies examining the effects of physical activity on ovulation showed that the length of time engaging in exercise was more harmful than the type of exercise. These studies revealed that exercise, even vigorous, for 30-60 minutes per day had a decrease in anovulatory infertility. Those that performed heavy exercises for more than 60 minutes had an increased risk of anovulation.
Sleep for Women's Reproductive Health
Practicing sleep hygiene and aiming for 8 hours of sleep is ideal to ensure you're getting enough shut-eye. Sleep is essential for reproductive health, including the signaling of hormones within the circadian rhythm.
Practicing Safe Sex for Women's Reproductive Health
Following safe sex guidelines protects your reproductive health and decreases your chance of contracting an STD. One of the best ways to support your reproductive wellness is to have one partner at a time, who also is only having sexual encounters with you.
Weight Management for Women's Reproductive Health
Working with an integrative healthcare provider that looks at all aspects of health is a great fit for this. Sometimes weight management goes beyond just the food you are eating. Stress, environmental exposures, and mental and emotional health all contribute to your body weight.
Nutrition for Women's Reproductive Health
You’re nutrition regimen should always be individualized to your health needs. If your reproductive health goal is to conceive, the Fertility Diet backed by a study done at Harvard University has shown promising results. This nutrition plan emphasizes omega-3 fatty acids, seafood, poultry, whole grains, fruits, and vegetables for better fertility outcomes in both men and women.
Botanicals for Women's Reproductive Health
There are a handful of botanicals that can have a direct or indirect effect on fertility enhancement. The eleven plants in this review show that botanicals like Licorice, Camellia sinensis, Trifolium pratense, Ashwagandha, and Vitex all have hormone-regulating abilities and influence fertility. One botanical listed, Chamomile, is also a botanical used for relaxation and sleep.
Acupuncture for Women's Reproductive Health
An acupuncturist is a trained healthcare practitioner who addresses dysfunction by working on meridian patterns within the body. Amongst many health conditions, acupuncture has been widely used to enhance fertility.
Talk Therapy for Women's Reproductive Health
Talking with a skilled therapist is advised if you have been struggling with reproductive health issues or infertility. For infertility counseling, you'll want to see a specialist who can best support your reproductive journey. If all avenues of conventional and holistic medicine have been investigated, your next step may be to consult a genetic counselor for fertility treatment. Contacting the right organization is critical if you are struggling with substance abuse. Attending AA meetings or Narcotics Anonymous meetings is helpful in the prevention of relapsing.
The type of lifestyle you have is a major influence on reproductive health. Other areas like diet, environment, and genetics also play a part. Taking a whole-person approach to addressing or optimizing your reproductive health will ultimately get you the best desired outcomes. Working with a skilled provider that can order functional medicine labs is an efficient way to get root cause answers. The most challenging yet rewarding part is on you. That is to prioritize health, leaving you feeling good mentally, emotionally, and physically. This combined with guidance from your doctor, will set you in the right direction regarding your reproductive health.
Lab Tests in This Article
- Abuse, N. I. on D. (2020, January 22). Substance Use in Women DrugFacts. National Institute on Drug Abuse https://nida.nih.gov/publications/drugfacts/substance-use-in-women
- Alcohol·s Effects on Female Reproductive Function. (n.d.). https://pubs.niaaa.nih.gov/publications/arh26-4/274-281.htm
- Beroukhim, G., Esencan, E., & Seifer, D. B. (2022). Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review. Reproductive Biology and Endocrinology, 20(1). https://doi.org/10.1186/s12958-022-00889-3
- Cariati, F., D’Argenio, V., & Tomaiuolo, R. (2019). The evolving role of genetic tests in reproductive medicine. Journal of Translational Medicine, 17(1). https://doi.org/10.1186/s12967-019-2019-8
- Chamomile. (2020, May). Retrieved from NCCIH website: https://www.nccih.nih.gov/health/chamomile
- Cleveland Clinic. (2019, January 19). Female Reproductive System. https://my.clevelandclinic.org/health/articles/9118-female-reproductive-system
- Cochrane, S., Smith, C. A., Possamai-Inesedy, A., & Bensoussan, A. (2016). Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning Assessed by a Pilot Pragmatic Randomised Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2016, 1–11. https://doi.org/10.1155/2016/3587569
- de Angelis, C., Nardone, A., Garifalos, F., Pivonello, C., Sansone, A., Conforti, A., … Pivonello, R. (2020). Smoke, alcohol and drug addiction and female fertility. Reproductive Biology and Endocrinology, 18(1). https://doi.org/10.1186/s12958-020-0567-7
- Gaskins, A. J., & Chavarro, J. E. (2018). Diet and fertility: a review. American Journal of Obstetrics and Gynecology, 218(4), 379–389. https://doi.org/10.1016/j.ajog.2017.08.010
- Hakimi, O., & Cameron, L.-C. (2016). Effect of Exercise on Ovulation: A Systematic Review. Sports Medicine, 47(8), 1555–1567. https://doi.org/10.1007/s40279-016-0669-8
- John Hopkins Medicine. (2019). Safer Sex Guidelines. https://www.hopkinsmedicine.org/health/wellness-and-prevention/safer-sex-guidelines
- Lateef, O. M., & Akintubosun, M. O. (2020). Sleep and Reproductive Health. Journal of Circadian Rhythms, 18(1). https://doi.org/10.5334/jcr.190
- Mathieson, I., Day, F. R., Barban, N., Tropf, F. C., Brazel, D. M., van Heemst, D., … Chasman, D. I. (2023). Genome-wide analysis identifies genetic effects on reproductive success and ongoing natural selection at the FADS locus. Nature Human Behaviour, 1–12. https://doi.org/10.1038/s41562-023-01528-6
- Mayo Clinic. (2018). Common STD Symptoms. https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-symptoms/art-20047081
- Mena, G. P., Mielke, G. I., & Brown, W. J. (2019). The effect of physical activity on reproductive health outcomes in young women: a systematic review and meta-analysis. Human Reproduction Update, 25(5), 542–564. https://doi.org/10.1093/humupd/dmz013
- Nutrition and reproduction in women. (2006). Human Reproduction Update, 12(3), 193–207. https://doi.org/10.1093/humupd/dmk003
- Office On Women's Health. (2019, March 14). Healthy eating and women. https://www.womenshealth.gov/healthy-eating/healthy-eating-and-women
- Reproductive Health. (2018). Retrieved from National Institute of Environmental Health Sciences website: https://www.niehs.nih.gov/health/topics/conditions/repro-health/index.cfm
- Richmond, C. (n.d.). What to Expect at Your First NA Meeting. https://www.webmd.com/mental-health/addiction/narcotics-anonymous-what-to-expect
- Smith, M., Robinson, L., & Segal, J. (2018). Overcoming drug addiction: How to stop abusing drugs, find treatment, and start recovery. https://www.helpguide.org/articles/addictions/overcoming-drug-addiction.htm
- Tsevat, D. G., Wiesenfeld, H. C., Parks, C., & Peipert, J. F. (2017). Sexually transmitted diseases and infertility. American Journal of Obstetrics and Gynecology, 216(1), 1–9. https://doi.org/10.1016/j.ajog.2016.08.008
- Wang, A., Padula, A., Sirota, M., & Woodruff, T. J. (2016). Environmental influences on reproductive health: the importance of chemical exposures. Fertility and Sterility, 106(4), 905–929. https://doi.org/10.1016/j.fertnstert.2016.07.1076
- Weight, fertility, and pregnancy. (2018, January 10). https://www.womenshealth.gov/healthy-weight/weight-fertility-and-pregnancy
- Zwillich, T. (n.d.). Study Shows Toxic Chemicals in Newborns. https://www.webmd.com/parenting/baby/news/20050714/study-shows-toxic-chemicals-in-newborns