Even if you're not thinking about having children or becoming pregnant any time soon, it's not a bad idea to learn how to spot the signs that you might be infertile or have fertility issues. Though typically treatable, fertility problems are relatively common: the Center for Disease Control (CDC) states that approximately 10% of women in the U.S. aged 15 to 44 have difficulty becoming pregnant or staying pregnant. However, it should be noted that fertility is not only a women's issue. According to the CDC, in about 8% of couples with fertility issues, a "male" factor was the only detectable cause.
To learn more, Bustle reached out to Dr. Nataki Douglas, MD, PhD, Chair of the Modern Fertility Medical Advisory Board. Below, she provides her expertise on the signs of infertility that people with ovaries should be aware of. That said, it's important to keep in mind that none of the symptoms below are absolute signs that you're infertile, and in many cases, infertility is temporary and treatable. So if the signs below sound familiar to you, don't panic. If possible, schedule an appointment with your doctor so you can get all the facts and protect both your health and your peace of mind.
With that said, here are nine signs that you might be infertile.
1. Your Flow Is Way Off
If you've noticed that your periods have been way heavier than normal lately, you should know that heavy menstrual bleeding (or menorhhagia) can be a sign of some health issues that can cause infertility. According to the Mayo Clinic, menorhhagia can have many different causes — certain medications, IUDs, and even complications with pregnancies can cause heavy vaginal bleeding. However, a common cause of menorhhagia is a hormone imbalance which results in menstrual cycles without ovulation. As The Mayo Clinic explains on their website, the body produces progesterone — the hormone most responsible for keeping periods regular — when an egg is released from the ovaries. So if your periods have been particularly heavy, that might mean no eggs are being released.
As you probably already know, ovulation is essential to pregnancy. But even if you're not dealing with menorhhagia, it's not a bad idea for you to talk to your gynecologist about any abnormal changes in your flow — because heavy periods can also point to other health issues, such as a bleeding disorder.
2. Your Periods Are Super Irregular
If your periods are occasionally off by a few days, that's probably not a big deal. If your periods are so irregular that you gave up on tracking your menstrual cycle a long time ago, though, then their irregularity could be a sign of a problem. "If you get irregular periods ... it's possible you have Polycystic Ovary Syndrome (PCOS)," Dr. Douglas says. She says PCOS is one of the leading causes of infertility because, due to the irregular cycle, it’s nearly impossible to predict ovulation timing (if you're ovulating at all). "However, PCOS is treatable, and OBGYNs often use hormone testing (AMH and Testosterone) to get a better picture of PCOS," Dr. Douglas says.
Between 5% and 10% of women between the ages of 15 and 44 have PCOS, According to Womenshealth.gov. Further, the Mayo Clinic confirms that a menstrual cycle that's too long, too short, irregular or absent can mean you're not ovulating. Unfortunately, irregular ovulation (which is clinically referred to as anovulation) accounts for 30% to 40% of all women's infertility cases, according to WebMD. Luckily, though, treatments for anovulation do exist, so if you are diagnosed with this condition and want to become pregnant some day, know that things aren't hopeless.
3. You Don't Have Periods At All
Dr. Douglas says another culprit of irregular or absent menses could be Premature Ovarian Insufficiency (POI). "POI occurs when ovaries cease functioning before the age of 40, and when you stop ovulating, it can be very challenging to get pregnant," she says. Dr. Douglas tells Bustle if you have POI, you experience perimenopause much earlier in life than average — think hot flashes, vaginal dryness, and decreased libido.
People with POI have options for getting pregnant, though, Dr. Douglas says. "That said, it's very important to consult an OBGYN and check in on your hormones to see if you might have the conditions, [POI or PCOS] since the symptoms are sometimes hard to detect without further information."
While the majority of people with ovaries can expect to experience reduced fertility when they reach 40, the US Department of Health and Human Services states that reduced fertility and irregular periods can happen in people with POI as early as their teen years. It's also important to know that the condition can be hereditary: about 10% to 20% of people who suffer from POI have a family history of the condition.
4. You're Experiencing Painful Periods Or Pain During Sex
Dr. Douglas tells Bustle that pain during periods, intercourse, bowel movements, and urination could all point to endometriosis, where the endometrial tissue doesn't properly shed in monthly periods and results in growth of excess tissue. "This can lead to blockage of the fallopian tubes, and thus infertility," Dr. Douglas says. She suggests seeing your doctor if you're experiencing symptoms.
The Mayo Clinic alone diagnoses and treats more than 1,500 people each year with endometriosis, or pelvic pain associated with the condition; and the American Society for Reproductive Medicine states that 30% to 50% of people with endometriosis may experience infertility. That said, pain during periods alone doesn't automatically indicate infertility.
5. You've Suddenly Developed Severe Acne
Changes in your skin, like the onset of adult acne from seemingly nowhere, could be a sign that your hormone levels are off. More specifically, sudden severe acne could mean that you're suffering from PCOS, which — as Dr. Douglas establishes above — is one of the leading causes of fertility issues in people with ovaries.
6. You've Noticed Dark Hair Growing In New Places On Your Body
Since PCOS occurs when ovaries produce more androgens (aka sex hormones like testosterone) than they're supposed to, people with PCOS usually have to deal with unwanted facial and/or body hair. If you've started growing excess, dark facial and/or body hair yourself, you could be suffering from undiagnosed PCOS — which can make getting pregnant difficult.
However, remember that PCOS is treatable, and it doesn't always mean your chances of having a biological child are slim. There are a number of medications designed to help people with PCOS ovulate so they can become pregnant.
7. You're Experiencing Hair Loss — Or Your Hair Is Thinning
Hair loss can happen for several reasons, and not all of them are directly related to fertility. WebMD lists autoimmune diseases, thyroid problems, anemia, psoriasis, and even pregnancy as possible causes for hair loss in people with ovaries. That said, just like PCOS can cause excess facial body hair, PCOS can also cause thinning hair on the face and body (referred to as "female pattern hair loss").
8. Your Sex Drive Has Decreased Dramatically
A major decrease in your sex drive could signify lots of things besides infertility. Your drop in desire might just mean you're extremely stressed out or depressed. Certain medications can mess with sex drive, too. However, it's worth noting that, in addition to contributing to infertility, endometriosis can cause sexual desire to decrease in people with ovaries. It can also cause sex to be extremely painful. In fact, a 2017 study published in the journal Reproductive Sciences reviewed nine studies on the topic of endometriosis and sexual function, all of which were published between 2000 and 2016. It found that, overall, around two thirds of people with endometriosis have some form of sexual dysfunction. Again, only your doctor can tell you for certain if your lack of sex drive points to fertility issues.
9. You're Gaining Weight For No Clear Reason
Unexplained weight gain can be yet another sign of PCOS. In addition to having an excess of androgens, people with PCOS also have a higher resistance to insulin. This makes most people who suffer from the hormonal disorder gain weight despite not changing their diets or levels of activity. (It is possible to healthily lose weight with PCOS, however, if that's your goal.) So if you seem to gain weight for no reason — especially if this wasn't always the case for you — it could be a sign of infertility.
The Bottom Line
Again, none of these symptoms are 100% sure signs of irreversible infertility. But all of them suggest that you might be experiencing fertility issues or some other kind of health problems — so make an appointment with your doctor if they sound familiar, even if you're not planning on getting pregnant soon (or ever).
Barbara, G., Facchin, F., Buggio, L., Somigliana, E., Berlanda, N., Kustermann, A., & Vercellini, P. (2017). What Is Known and Unknown About the Association Between Endometriosis and Sexual Functioning: A Systematic Review of the Literature. Retrieved from https://journals.sagepub.com/doi/pdf/10.1177/1933719117707054.
Dr. Nataki Douglas, MD, PhD; Chair of the Modern Fertility Medical Advisory Board. https://modernfertility.com/blog/medicalboard/