Enhancing Reproductive Health with Functional Medicine

Enhancing Reproductive Health with Functional Medicine

Infertility rates have increased substantially in the past few decades with 1 in 5 women of reproductive-age in the United States affected today. The term infertility is defined as the failure to achieve pregnancy after one year of unprotected sexual intercourse¹. This is not just a woman’s issue; infertility can also be due to male factors or a combination of male and female factors. Interestingly, at least half of all infertility cases have a male factor as a major or contributing cause².

So, what are the root causes of this worldwide fertility problem? This blog post details some of the main factors that contribute to infertility along with functional medicine approaches to correct these underlying dysfunctions for optimal reproductive health.

It always goes back to food

The Standard American Diet (SAD) is just that; SAD. It is full of highly-processed foods high in sugars, simple carbohydrates, and inflammatory fats, while also lacking essential nutrients. Proper nutrition plays a vital role in fertility-related outcomes. Vitamins and minerals are required for maintaining the normal quality of oocytes and embryo fertilization, maturation, and implantation³.

A Mediterranean-type diet, which includes large amounts of vegetables, fish, olive oil and other healthy fats along with low red meat consumption and simple sugars, has shown to enhance fertility, to increase the probability of pregnancy by couples undergoing in vitro fertilization, and has positive effects on insulin resistance and metabolic disturbances, both important for fertility³. One study of 17,544 women found that women who focused on a ‘fertility diet’ (plant protein from vegetable sources, full-fat dairy foods, iron, and monounsaturated fats) were found to have a 66% lower risk of ovulatory disorder infertility and a 27% lower risk of infertility due to other causes⁴. These types of eating patterns have also shown to improve semen quality including morphology, motility, and concentration¹. To help drive the nutrition point home, higher fast food intake and lower fruit intake are associated with infertility³.

Some tips for better nutrition:

• Shop the perimeter of the grocery store, loading up on fresh fruits and vegetables. Wash and prep them when you get home so they’re ready to eat all week.
• Eat organic when possible. The Dirty Dozen and Clean Fifteen, published by the Environmental Working Group, are great resources for knowing which fruits and vegetables have the highest and lowest amounts of pesticides.
• Eat the rainbow. Incorporate a variety of different colored foods into your diet.
• Cut down on highly-processed and fast foods. Try cooking an extra meal or two at home each week. Make enough for leftovers for easy lunches or dinners throughout the week.
• Go for a 15-minute walk after eating to help with digestion and blood sugar regulation.

Having a functional medicine-trained pharmacist or health coach on board can help guide you in the right direction in making better food choices and selecting high-quality supplements to fill in any nutritional gaps.

Those pesky and persistent environmental toxins

Environmental toxins can damage both female and male reproductive systems, disrupt the endocrine system, and impairs fetal viability⁵. Epidemiological studies show that certain endocrine disrupting chemicals (EDCs) have adverse effects on fertility including reduced gestational age, weight, pregnancy gain, increased risk for miscarriage, and time to pregnancy in women⁶. Some of the worst offenders are pesticides and herbicides, bisphenol A (BPA), polychlorinated biphenyls (PCBs), and dioxins though there are many other agents that negatively impact fertility⁵.

Reducing and/or avoiding exposures to these toxins should be of utmost importance for those wanting to enhance fertility. This blog discusses lifestyle modifications you can make to reduce your overall toxin exposure.

Stress

You may have heard that “stress is bad for the baby”, and the same applies to couples trying to conceive. When under stress, the body is focused on survival over other physiological functions such as growth and reproduction. Chronic stress triggers the body to release high amounts of cortisol which negatively impacts fertility by inhibiting the secretion of gonadotropin-releasing hormone (GnRH). Decreased amounts of GnRH results in less follicle-stimulating hormone (FSH) and luteinizing hormone (LH), key players in ovarian follicle release and maturation. Furthermore, maternal stress can alter fetal development⁷.

We all experience stress so it’s important to regularly engage in practices that help manage stress. One way to do that is to sleep! The CDC recommends adults get 7+ hours of sleep every night⁸. Have trouble getting to sleep? Check out this blog post full of tips on how to get a better night’s sleep.

You can get some other tips on managing the stress response by visiting this blog post- Flip the Switch on Stress: Simple Ways to Nurture Your Body.

Underlying conditions

• Polycystic Ovarian Syndrome (PCOS) affects anywhere from 5-20% of reproductive-age women and is the most common cause of female infertility in the United States. Metabolic features are present in a large percentage of those with PCOS, including obesity, insulin resistance, hyperlipidemia, and hyperandrogenism. Addressing contributing factors to PCOS and foundations of health can dramatically improve or reverse PCOS symptoms, including fertility. Check out our two blog posts all about PCOS: PCOS: A lifestyle disorder and Improving PCOS using Lifestyle Medicine.  

• Endometriosis, a gynecological condition where the endometrial tissue develops outside the uterus, can impact fertility through anatomical distortions due to adhesions and fibrosis, endocrine abnormalities, or immunological disturbances⁹. Although a challenging condition to treat, addressing underlying dysfunction such as chronic inflammation, stress, and immune system imbalance and gut health can have profound effects.

• Variations in weight (underweight, overweight or obese) can be detrimental to reproductive health. One study found that women who were underweight (BMI < 20 kg/m2) or obese (BMI ≥ 30 kg/m²) had a higher risk of infertility¹. High BMI has been connected to a longer time to conceive, decreased pregnancy rates, increased requirements for gonadotrophins and higher miscarriage events as well as adverse pregnancy outcomes such as gestational diabetes, hypertension and premature labor¹⁰. Male obesity has also been associated with increased risk of infertility¹.

Bottom Line

Now that you have a better understanding of underlying factors contributing to infertility and the functional medicine approach to correcting them, you are ready to take control of your fertility! If you or your partner are suffering from infertility and would like to try the functional medicine approach, reach out to one of our exceptional pharmacists here at PharmToTable. We are happy to help you on your journey to parenthood!  Book an appointment or schedule a free 15-minute discovery call today!

Written by Megan Morrison, PharmD, and Kayla Brotherton, PharmD Candidate, Class of 2022

References:

1. Panth N, Gavarkovs A, Tamez M, Mattei J. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Front Public Health. 2018;6:211. Published 2018 Jul 31. doi:10.3389/fpubh.2018.00211
2. Male infertility: Causes & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17201-male-infertility#:~:text=Infertility%20affects%20one%20in%20every,to%20conceive%20suffer%20from%20infertility. Published 2021. Accessed April 21, 2022. 
3. Kinga Skoracka, Alicja Ewa Ratajczak, Anna Maria Rychter, Agnieszka Dobrowolska, Iwona Krela-Kaźmierczak, Female Fertility and the Nutritional Approach: The Most Essential Aspects, Advances in Nutrition, Volume 12, Issue 6, November 2021, Pages 2372–2386, https://doi.org/10.1093/advances/nmab068
4. Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007 Nov;110(5):1050-8. doi: 10.1097/01.AOG.0000287293.25465.e1. PMID: 17978119.
5. Pizzorno J. Environmental Toxins and Infertility. Integr Med (Encinitas). 2018;17(2):8-11.
6. Rattan S, Zhou C, Chiang C, Mahalingam S, Brehm E, Flaws JA. Exposure to endocrine disruptors during adulthood: consequences for female fertility. J Endocrinol. 2017 Jun;233(3):R109-R129. doi: 10.1530/JOE-17-0023. Epub 2017 Mar 29. PMID: 28356401; PMCID: PMC5479690.

7. Joseph DN, Whirledge S. Stress and the HPA Axis: Balancing Homeostasis and Fertility. Int J Mol Sci. 2017;18(10):2224. Published 2017 Oct 24. doi:10.3390/ijms18102224
8. CDC – how much sleep do I need? – sleep and sleep disorders. Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html. Published March 2, 2017. Accessed April 21, 2022. 
9. Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand. 2017 Jun;96(6):659-667. doi: 10.1111/aogs.13082. Epub 2017 Jan 30. PMID: 27998009.
10. Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol. 2018;16(1):22. Published 2018 Mar 9. doi:10.1186/s12958-018-0336-z