News Moms Need

Hormones are the chemicals within the body that send signals to set off various functions.  Rising and falling levels of different hormones are essential in reproduction, pregnancy and birth.  Here are the main ones involved in having a baby:

Estrogen and progesterone – Prior to pregnancy, these are produced in the ovaries and they tell the lining of the uterus to thicken during each menstrual cycle.  And they tell the lining to cast itself off if pregnancy does not occur. Once an egg is fertilized, increasing levels of estrogen and progesterone prevent ovulation from occurring again.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – These hormones are made by the pituitary gland, located at the base of the brain.  FSH causes an egg to ripen in one of the ovaries and LH triggers the egg’s release.

Gonadotropin-releasing hormone (GnRH) – Also produced in the pituitary gland, this hormone signals the production of FSH and LH.

Human chorionic gonadotropin (hCG) – This hormone is produced by the fertilized and dividing/growing egg.  It tells the body to increase estrogen and progesterone production.  This is the hormone that pregnancy tests look for in a urine sample (approx. 6-12 days after fertilization).

Rising and lowering hormone levels are essential for the process of reproduction and the maintenance of pregnancy.  What’s important is that the individual hormones rise and fall in a coordinated dance with masterful timing.  Pretty impressive stuff.

Chlamydia is a bacterium that causes a sexually transmitted infection (STI). A chlamydial infection contracted before or during pregnancy can be the cause of reproductive problems, so it’s important to clear it up a.s.a.p. About 2.8 million new cases of this infection occur every year in the U. S. in both sexes, making this one of the most common STIs. It occurs most frequently in people under age 25.

Chlamydia usually has no symptoms, although some infected women experience vaginal discharge and burning on urination. Untreated, chlamydia can spread to the upper genital tract (uterus, fallopian tubes and ovaries), resulting in pelvic inflammatory disease (PID), often with a superinfection with other bacteria – so not nice!  And PID can damage a woman’s fallopian tubes and lead to ectopic pregnancy or infertility.

About 10 percent of pregnant women in the United States are infected with chlamydia. Untreated, they face an increased risk of premature rupture of the membranes (PROM) (bag of waters) and preterm delivery. Babies of untreated women often become infected during vaginal delivery, and infected babies can develop eye infections and pneumonia, which require treatment with antibiotics.

The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women be screened for chlamydia infection at the first prenatal visit. Testing is easy and is done on a urine sample or vaginal fluid obtained with a swab. The good news is that chlamydial infection can be cured with antibiotics that prevent complications for mom and baby. It’s important to note that the partner of an infected woman also should be treated, because the infection can be passed back and forth between sexually active couples.

Endometrium is the tissue that normally lines a woman’s uterus.  In endometriosis, this tissue grows in other places as well, like behind the uterus, on the fallopian tubes and ovaries, or just randomly within the pelvic cavity.  All this overgrowth of tissue can cause fertility issues for women who want to conceive. 

Regardless of where the endometrial tissue is located in the body, it continues to act as if it were part of the uterus.  Each month it thickens, breaks down and bleeds.  Trapped blood in your body cavity can irritate other tissues and cause inflammation, cysts, tumors, or adhesions, scar tissue that can stick to internal organs.  This can make for very heavy and painful menstrual periods.  Depending on the degree of extra tissue growth, a woman with endometriosis may also experience sharp pain during ovulation, during sex, or even during bowel movements and may have random bouts of diarrhea or constipation.

Unfortunately, we don’t yet know what causes endometriosis or how to stop it. While up to half of all women with endometriosis experience some fertility issues, most women with a mild to moderate case eventually are able to conceive.  If you think you may have endometriosis, make an appointment with your health care provider.  She can check for cysts and possible adhesions using ultrasound or MRI.  Sometimes a minor surgical procedure called laparoscopy (a scope is inserted through a small incision in the abdomen) is needed to view the extent of tissue growth within the abdomen.

There is no cure, but endometriosis can be treated with pain meds and with different hormone therapies, including contraceptives, to slow the growth of tissue.  If a woman is trying to conceive, however, this approach often is not helpful.  Many women with endometriosis undergo surgery, often performed with laparoscopy, to remove growths and scar tissue.  This procedure can significantly improve the chances for conception.

Polycystic ovary syndrome (PCOS) is a medical condition that can affect a woman’s menstrual cycle, hormones, ability to have children, heart, blood vessels, and appearance (especially excessive hair growth). Although women do  produce small levels of androgens, sometimes called male hormones, women with PCOS  typically have high levels of androgens.  They usually have missed or irregular periods and their ovaries can be swollen with many small cysts.  It is estimated that 6 to 10% of all women of reproductive age have PCOS, and evidence suggests that it may run in some families.

A woman’s ovaries have follicles, which are tiny sacs filled with liquid that hold her eggs. These sacs also are called cysts. For most women, approximately 20 eggs start to mature every month, with only one maturing fully. As this one egg grows, the follicle accumulates fluid in it. When the egg is mature, the follicle breaks open and releases it. The egg then travels through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place.

In women with PCOS, the ovary doesn’t produce all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid, but no one follicle becomes large enough. Instead, in some but not all women, some follicles may remain as cysts. Since no follicle becomes large enough and no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Additionally, the cysts make male hormones, which also prevent ovulation.

Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used.  Diet and weight loss are essential for overweight women.