Causes of Infertility (Hormonal)

Hormonal causes of infertility at a glance

  • When the delicate balance of several different hormones goes wrong at some point in the body, infertility is one possible result.
  • There are several health conditions that are specific to the endocrine (hormonal) system of the body.
  • Two of the more common infertility-causing endocrine conditions are hyperprolactinemia and thyroid disease.
  • There can also be other hormones that cause problems, but these are discussed elsewhere

Infertility caused by hormones guide

What is Hyperprolactinemia?
Symptoms of hyperprolactinemia
Diagnosing hyperprolactinemia
What is thyroid disease?

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Hyperprolactinemia is an overabundance of the hormone prolactin. Sub-fertility as a result of this increased level can occur in both men and women, and is found in up to one-third of women experiencing amenorrhea. Prolactin is secreted by the pituitary gland and is used by the pregnant female body to prepare breasts for milk production. The term “lactating,” often used to refer to nursing mothers, comes from “prolactin.” Galactorrhea, noticeable milk production from the breasts that occurs spontaneously during times other than when nursing, is often seen in patients with hyperprolactinemia. Being able to express milky fluid by pinching the nipples is normal.

Common causes of hyperprolactinemia

In about 30 percent of patients the cause for hyperprolactinemia is unknown.

  • Pituitary tumors, usually prolactinomas which are under 10 mm in diameter
  • Primary hypothyroidism
  • Ingestion of certain drugs, including phenothiazines, certain high blood pressure meds (especially a-methyldopa), tranquilizers and opioids, antinausea drugs, oral contraceptives
  • Chronic kidney failure and other medical condition
  • Hyperprolatinamia is sometimes associated with hypogonadotropinism and hypogonadism.

Symptoms of hyperprolactinemia

  • Irregular or absent menstrual periods
  • Headaches and visual difficulties
  • Loss of libido & sexual potency, in men
  • Lowered levels of LH and FSH
  • Symptoms of estrogen deficiency (such as those of menopause — hot flashes, dyspareunia) even in cases of normal estrogen production
  • Signs of increased levels of androgens in women


Hyperprolactinemia is diagnosed with blood tests to measure the following hormones:

  • Basal prolactin level (usually first thing in the morning, before shower or exercise and eating.)
  • Serum FSH, LH, & estradiol
  • TSH

Additional testing may include CT or MRI scans to identify tumors.

Treatment for hyperprolactinemia can include medications or hormone therapy.

Thyroid disease

Thyroid Disease is relatively common and refers to any disorder of the thyroid gland. The thyroid is located in the base of the neck on both sides of the lower part of the larynx and upper part of the trachea. In some cases of disease, the gland becomes noticeably enlarged. The thyroid has a crucial role in the body’s metabolism.Thyroid disease can cause female infertility by resulting in anovulation (lack of ovulation) and menstrual irregularity, luteal phase defect, and hyperprolactinemia.

Men with thyroid disease can have resulting low sperm count and reduced sperm motility. Generally, women with Hashimotos Thyroiditis (a kind of hypothyroidism) appear to have a slightly higher than normal risk of miscarriage.