When it comes to fertility, hormone balance and energy, we often focus on things like nutrition, stress, sleep or hormone levels. While these are all important, there is another piece of the puzzle that deserves more attention: mitochondria.

Mitochondria are often referred to as the powerhouses of the cell because they produce ATP, the energy currency that powers almost every process in the body. However, their role extends far beyond energy production. Mitochondria are involved in hormone production, DNA repair, immune function, inflammation regulation, cell signalling and healthy ageing.

Because mitochondria are involved in so many essential functions, dysfunction has been linked to a wide range of health concerns including fertility challenges, recurrent miscarriage, endometriosis, chronic fatigue, depression, autism spectrum disorder and age-related hormonal decline.

From a naturopathic perspective, supporting mitochondrial health is often an important part of improving overall wellbeing. Healthy mitochondria help create the foundation for healthy cells, healthy hormones and healthy ageing.

Mitochondria and Fertility

Fertility is one of the areas where mitochondrial health is particularly important.

Mitochondria help regulate energy production within both egg and sperm cells, but they are also involved in DNA repair, hormone production and healthy embryonic development.

One of the hormones produced with the help of mitochondrial function is pregnenolone. Pregnenolone is often referred to as the “mother hormone” because it serves as the precursor for progesterone, oestrogen, testosterone and cortisol. When mitochondrial function is compromised, hormone production can also be affected.

Mitochondria are also involved in glucose metabolism and blood sugar regulation. This is particularly relevant because unstable blood sugar levels can influence fertility, ovulation, hormone production and overall reproductive health.

Perhaps one of the most fascinating aspects of mitochondrial biology is that babies inherit their mitochondria exclusively from their mother. This means mitochondrial health doesn’t just affect fertility today. It may also influence the health and fertility of future generations.

For this reason, mitochondrial support can be an important consideration in preconception care and natural fertility support.

Why Egg Cells Need So Many Mitochondria

Egg cells (oocytes) are remarkable. They contain anywhere from 100,000 to more than one million mitochondria, far more than almost any other cell in the body. This enormous energy reserve is needed to support egg maturation, fertilisation and the earliest stages of embryonic development.

As women age, mitochondrial function within the ovaries gradually declines. By the age of 40, it is estimated that almost one-third of the mitochondria within oocytes are no longer functioning efficiently. This decline is one of the reasons fertility naturally decreases with age.

When fertilisation occurs, the egg does more than simply receive genetic material from the sperm. If there is DNA damage within the sperm, the oocyte uses its own mitochondrial reserves to help repair that damage. This process is essential for creating a healthy embryo.

Because of these demands, egg quality is closely tied to mitochondrial health.

Why Sperm Health Matters

While sperm are tiny compared to an egg, they contribute half of the genetic material needed to create a baby. Male fertility is often prioritized less then female fertility, yet male factor issues contribute to around 50% of fertility challenges.

Unlike egg cells, sperm contain only a few dozen mitochondria. These mitochondria are located within the midpiece of the sperm and provide the energy required for movement.

At the moment of conception, the sperm penetrates the egg and delivers its DNA into the oocyte. The sperm mitochondria themselves are not inherited by the baby. Instead, the egg uses its own mitochondrial resources to support early development and repair any damage present within the sperm DNA.

Sperm are particularly vulnerable to oxidative stress and damage from reactive oxygen species (ROS). Excessive oxidative stress can impair mitochondrial function, reduce motility and increase DNA fragmentation.

Sperm health also influences much more than fertilisation. Research suggests that sperm quality affects placental development and may contribute to miscarriage risk. This is why supporting sperm health is just as important as supporting egg quality when preparing for pregnancy.

Mitochondria, Perimenopause and Menopause

Mitochondrial health isn’t only associated with fertility – these tiny structures may also influence when a woman transitions into perimenopause and menopause.

As women age, the number and function of mitochondria within the ovaries gradually decline. Research suggests that by age 40, approximately one-third of mitochondria within oocytes are no longer functioning efficiently.

Human oocytes contain between 100,000 and more than one million mitochondria because egg maturation and early embryonic development require vast amounts of energy. The rate at which these mitochondria decline appears to influence reproductive ageing.

Research published in 2024 demonstrated that reducing mitochondrial DNA accelerated reproductive ageing in animal models. This suggests that mitochondrial function may play an important role in determining the pace of ovarian ageing and potentially the timing of perimenopause and menopause.

This may help explain why many women notice changes in energy, recovery, metabolic health and stress resilience during the perimenopausal transition, however there is much more involved (if you’d like to learn more about perimenopause and menopause, go on the wait list for my upcoming book Natural Menopause Support).

Researchers have also identified CoQ10 as an important nutrient within ovarian tissue. One landmark study found that age-related declines in egg quality were partly driven by reduced CoQ10 availability within the oocyte. Supplementation helped preserve ovarian reserve, improve egg quality and restore fertility in aged mice. Additional research has also demonstrated improvements in progesterone production.

While ageing is a natural process, supporting mitochondrial health may help support healthier ovarian ageing and improve resilience during the transition into perimenopause and menopause.

Mitochondria and Endometriosis

While we’re on the topic of women’s health, it’s worth exploring the connection between mitochondria and endometriosis.

Many people think of endometriosis primarily as a hormonal condition, but there is also a significant immune and inflammatory component.

Women with endometriosis often experience increased oxidative stress, elevated inflammatory markers and altered immune function. Mitochondria are involved in all three of these processes.

When mitochondria become dysfunctional, they can produce excessive amounts of reactive oxygen species. This creates a cycle of oxidative stress and inflammation that may contribute to the growth and persistence of endometriosis lesions.

Mitochondria also play an important role in immune cell function and inflammatory signalling. When mitochondrial function is impaired, immune regulation can become disrupted, potentially contributing to the chronic inflammatory environment seen in endometriosis.

This is one reason why a holistic approach to endometriosis management often extends beyond hormones alone. Supporting mitochondrial health alongside nervous system regulation, immune function, gut health and hormonal balance may help address some of the underlying drivers involved in the condition.

Mitochondria, Mood and Brain Health

The brain is one of the most energy-demanding organs in the body.

Every thought, memory, movement and emotion requires energy. Healthy mitochondrial function helps support neurotransmitter production, nerve cell communication and overall brain function.

When mitochondrial function is impaired, symptoms such as brain fog, poor concentration, low mood and fatigue may occur.

Emerging research has also found that mitochondrial dysfunction is common in individuals with Autism Spectrum Disorder (ASD). Studies have identified abnormalities in mitochondrial energy production, increased oxidative stress and higher levels of neuroinflammation in some individuals with ASD.

Because mitochondria play such a central role in brain energy metabolism, supporting mitochondrial health may be an important consideration in conditions involving cognitive function, mood and neurological health.

Signs Your Mitochondria May Need Support

Some common signs that mitochondrial function may be struggling include:

• Persistent fatigue
• Poor exercise recovery
• Muscle weakness
• Brain fog
• Poor concentration
• Low mood
• Fertility challenges
• Hormonal imbalances
• Reduced resilience to stress
• Feeling older than your age

These symptoms can have many different causes, but mitochondrial dysfunction is one possible contributor worth considering.

Supporting Mitochondrial Health Naturally

Mitochondrial support is rarely about a single supplement. Instead, it involves creating an environment that allows these cellular powerhouses to function optimally.

Some of the ways mitochondrial health can be supported include:

• Prioritising quality sleep, as much of the body’s cellular repair occurs during sleep
• Maintaining stable blood sugar levels through a balanced diet
• Regular exercise, which stimulates the production of new mitochondria
• Spending time outdoors and supporting healthy circadian rhythms
• Cold exposure, which may help improve mitochondrial resilience and adaptation
• Supporting gut health and addressing dysbiosis where present
• Reducing exposure to environmental toxins where possible
• Ensuring adequate intake of nutrients required for mitochondrial function
• Supporting nervous system regulation and reducing chronic stress

Because mitochondrial health sits at the intersection of fertility, hormones, inflammation, energy production and healthy ageing, it can be a valuable area of focus in naturopathic care.

If you’re struggling with fertility challenges, subfertility, recurrent miscarriage, endometriosis, fatigue, hormone imbalances or perimenopausal symptoms, supporting mitochondrial health may be one piece of the puzzle worth exploring.

References

1. Annesley, S. J., & Fisher, P. R. (2019). Mitochondria in Health and Disease. Cells, 8(7), 680. https://doi.org/10.3390/cells8070680
2. Ben-Meir, A., Burstein, E., Borrego-Alvarez, A., Chong, J., Wong, E., Yavorska, T., Naranian, T., Chi, M., Wang, Y., Bentov, Y., Alexis, J., Meriano, J., Sung, H. K., Gasser, D. L., Moley, K. H., Hekimi, S., Casper, R. F., & Jurisicova, A. (2015). Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging cell, 14(5), 887–895. https://doi.org/10.1111/acel.12368
3. Ben-Meir, A., Kim, K., McQuaid, R., Esfandiari, N., Bentov, Y., Casper, R. F., & Jurisicova, A. (2019). Co-Enzyme Q10 Supplementation Rescues Cumulus Cells Dysfunction in a Maternal Aging Model. Antioxidants (Basel, Switzerland), 8(3), 58. https://doi.org/10.3390/antiox8030058
4. Chiang, J. L., Shukla, P., Pagidas, K., Ahmed, N. S., Karri, S., Gunn, D. D., Hurd, W. W., & Singh, K. K. (2020). Mitochondria in Ovarian Aging and Reproductive Longevity. Ageing research reviews, 63, 101168. https://doi.org/10.1016/j.arr.2020.101168
5. Khaliulin, I., Hamoudi, W., & Amal, H. (2025). The multifaceted role of mitochondria in autism spectrum disorder. Molecular psychiatry, 30(2), 629–650. https://doi.org/10.1038/s41380-024-02725-z
6. Kobayashi, H., & Imanaka, S. (2024). Mitochondrial DNA Damage and Its Repair Mechanisms in Aging Oocytes. International journal of molecular sciences, 25(23), 13144. https://doi.org/10.3390/ijms252313144
7. Kramer, P., & Bressan, P. (2018). Our (Mother’s) Mitochondria and Our Mind. Perspectives on psychological science : a journal of the Association for Psychological Science, 13(1), 88–100. https://doi.org/10.1177/1745691617718356
8. Long, S., Zheng, Y., Deng, X., Guo, J., Xu, Z., Scharffetter-Kochanek, K., Dou, Y., & Jiang, M. (2024). Maintaining mitochondrial DNA copy number mitigates ROS-induced oocyte decline and female reproductive aging. Communications biology, 7(1), 1229. https://doi.org/10.1038/s42003-024-06888-x
9. Melhuish Beaupre, L. M., Brown, G. M., Braganza, N. A., Kennedy, J. L., & Gonçalves, V. F. (2022). Mitochondria’s role in sleep: Novel insights from sleep deprivation and restriction studies. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry, 23(1), 1–13. https://doi.org/10.1080/15622975.2021.1907723
10. Tesarik, J., & Mendoza-Tesarik, R. (2023). Mitochondria in Human Fertility and Infertility. International journal of molecular sciences, 24(10), 8950. https://doi.org/10.3390/ijms24108950
11. May-Panloup, P., Boucret, L., Chao de la Barca, J. M., Desquiret-Dumas, V., Ferré-L’Hotellier, V., Morinière, C., Descamps, P., Procaccio, V., & Reynier, P. (2016). Ovarian ageing: the role of mitochondria in oocytes and follicles. Human reproduction update, 22(6), 725–743. https://doi.org/10.1093/humupd/dmw028
12. Vaught, R. C., & Dowling, D. K. (2018). Maternal inheritance of mitochondria: implications for male fertility?. Reproduction (Cambridge, England), 155(4), R159–R168. https://doi.org/10.1530/REP-17-0600
13. Wen, Y., & Yao, Y. (2021). Autism Spectrum Disorders: The Mitochondria Connection. In A. M. Grabrucker (Ed.), Autism Spectrum Disorders. Exon Publications. https://doi.org/10.36255/exonpublications.autismspectrumdisorders.2021.mitochondria

The post Mitochondria and Fertility: Egg Quality, Endometriosis, Menopause and Healthy Ageing appeared first on Alison Mitchell Naturopath.

When we think about polycystic ovary syndrome (PCOS), we often focus on the elevated testosterone levels associated with the condition. But did you know that PCOS also involves imbalances in oestrogen? In fact, women with PCOS often experience prolonged exposure to high levels of oestrogen due to an extended follicular phase. This extended phase can contribute to many of the symptoms associated with PCOS.

Let’s take a closer look at how oestrogen plays a significant role in PCOS, how this prolonged follicular phase leads to oestrogen dominance, and why it’s important to consider hormonal balance beyond just testosterone.

PCOS: It’s More Than Just High Testosterone

Yes, elevated testosterone is a hallmark of PCOS, but it’s not the only hormone at play. In women with PCOS, the menstrual cycle is often disrupted. Specifically, the follicular phase, which is the first half of the cycle where oestrogen rises to prepare for ovulation, can become much longer than normal. When ovulation doesn’t occur regularly or at all, the body experiences a prolonged period of high oestrogen without the counteracting effects of progesterone, which rises after ovulation, released from the corpus luteum.

This extended exposure to oestrogen contributes to many of the symptoms experienced by those with PCOS, but aren’t always easy to be explained by the evelated levels of insulin and testosterone. So keep in mind it’s not just about high testosterone—oestrogen plays a big role, too!

Signs of Excess Oestrogen in PCOS

If you have PCOS, you might be familiar with some of the signs of oestrogen dominance, such as:

• Breast tenderness
• Heavy or prolonged periods
• Bloating or water retention
• Mood swings and irritability
• Weight gain, especially around the hips and thighs

These symptoms are the result of an imbalance between oestrogen and progesterone. When oestrogen is allowed to remain elevated for too long without progesterone to balance it out, you may start to notice these classic signs of oestrogen dominance.

The Phases of the Menstrual Cycle

To understand how oestrogen dominance happens in PCOS, let’s briefly review the phases of a normal menstrual cycle:

1. Menstrual Phase – This is when you get your period, and the uterine lining is shed.
2. Follicular Phase – Oestrogen rises as your body prepares for ovulation. For many women with PCOS, this phase can be prolonged.
3. Ovulation – Ideally, a mature egg is released during ovulation. Oestrogen needs to peak in order to trigger a surge of LH, which then triggers the egg to be released from the follicle. For many women with PCOS, ovulation doesn’t occur regularly, leading to what’s called an anovulatory cycle, or an extended follicular phase.
4. Luteal Phase – After ovulation, the remainder of the follicle from which the egg from release – the corpus luteum – releases progesterone. Progesterone levels rise in the luteal phase, which balances the effects of oestrogen. However, if ovulation doesn’t happen, there’s no significant rise in progesterone, leading to relative oestrogen excess.

In PCOS, it’s common to have anovulatory cycles, meaning ovulation doesn’t occur, and the body doesn’t produce the necessary progesterone to balance out the high oestrogen levels. This leaves many women stuck in an extended follicular phase with prolonged exposure to oestrogen.

How Testosterone Can Convert to Oestrogen

Another important factor to consider in PCOS is how testosterone can be converted into oestrogen. This happens through a process called aromatisation, where testosterone is transformed into oestrogen in the body’s tissues, including fat cells. For women with PCOS, who often have elevated levels of testosterone, this can result in more oestrogen being produced, contributing further to the oestrogen dominance that many experience (Xu et al., 2024).

Increased Sensitivity to Oestrogen in PCOS

Interestingly, not only are oestrogen levels higher for longer in many women with PCOS, but there’s also evidence to suggest that their oestrogen receptors are more sensitive. This means that even if the levels of oestrogen aren’t dramatically high, the body may respond more strongly to it, intensifying the symptoms of oestrogen dominance (Xu et al., 2024). This heightened sensitivity further contributes to the hormonal imbalance that can make PCOS so challenging to manage.

The Impact of Endocrine Disrupting Chemicals (EDCs)

As if managing PCOS wasn’t complex enough, exposure to endocrine-disrupting chemicals (EDCs), such as bisphenol A (BPA), can further complicate the hormonal picture. Research has shown that women with PCOS often have elevated levels of BPA in their plasma, urine, or follicular fluid. BPA can mimic oestrogen and bind to oestrogen receptors, increasing their activity. This leads to more pronounced symptoms of oestrogen dominance and is linked to insulin resistance, polycystic ovarian morphology on ultrasound, and even markers of chronic low-grade inflammation (Srnovršnik et al., 2023).

If you have PCOS and are concerned about environmental factors like EDCs, it’s worth considering ways to reduce your exposure to BPA and other hormone disruptors, as these chemicals may worsen the hormonal imbalances associated with the condition.

Read more about endocrine disrupting chemicals and their impact on hormones and fertility here and here

Low SHBG Levels in PCOS and Its Effect on Oestrogen and Testosterone

Another key factor in PCOS is the role of sex hormone-binding globulin (SHBG). SHBG is a protein that binds to hormones like oestrogen and testosterone, controlling how much of these hormones are “free” and active in the body. Women with PCOS tend to have low SHBG levels, meaning they have more free (unbound) oestrogen and testosterone circulating in the bloodstream. This not only contributes to higher androgen symptoms (like acne and male pattern hair loss) but also increases the effects of oestrogen on the body (Emanuel et al., 2022).

Want to Learn More About PCOS?

If you’re dealing with PCOS and want to dive deeper into understanding how these hormonal imbalances affect your health, I’ve written several other blog posts on this topic. Check them out here:

Busting PCOS Myths

A Holistic Guide to PCOS

If you’d like to know more about hormones and how they affect your health and wellbeing, and how you can support your hormonal wellbeing and cyclical health, I would love you to look into my e-course The Cyclical Woman

Final Thoughts

PCOS is a complex condition that involves more than just high testosterone. The extended follicular phase, lack of progesterone due to anovulation, increased aromatisation of testosterone to oestrogen, and heightened oestrogen receptor sensitivity all contribute to the hormonal imbalances experienced by those with PCOS. By understanding how oestrogen plays into the bigger picture, you can take steps to manage your symptoms more effectively and work towards achieving better hormonal balance.

References

Emanuel, R. H. K., Roberts, J., Docherty, P. D., Lunt, H., Campbell, R. E., & Möller, K. (2022). A review of the hormones involved in the endocrine dysfunctions of polycystic ovary syndrome and their interactions. Frontiers in Endocrinology (Lausanne), 13, Article 1017468. https://doi.org/10.3389/fendo.2022.1017468

Srnovršnik, T., Virant-Klun, I., & Pinter, B. (2023). Polycystic ovary syndrome and endocrine disruptors (bisphenols, parabens, and triclosan) – A systematic review. Life (Basel), 13(1), 138. https://doi.org/10.3390/life13010138

Xu, Y., et al. (2024). Roles of estrogen and its receptors in polycystic ovary syndrome. Frontiers in Cell and Developmental Biology, 12, Article 1395331. https://doi.org/10.3389/fcell.2024.1395331

The post PCOS and Oestrogen: The Hidden Hormonal Imbalance You Need to Know About appeared first on Alison Mitchell Naturopath.

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Do your hormones have a mind of their own? Maybe it’s time you took back some control.

The food you eat can have a big impact on the health of your hormones, and if you’d like to learn some ways to positively influence your hormonal health, you might like to come along to my next talk.

This will be a casual talk with the content targeted to you, with time for Q & A.

Yummy food will be served (lovingly prepared by Glenda from SOLB) and you will receive recipes and handouts on the night.

Details:

Thursday 29th January 2015

5:30pm – 6:30pm

Short Order Long Black Cafe, Windsor. Shop 7, 266 George St, Windsor, NSW 2756 (02) 4587 9222

Tickets are $20 (plus booking fee) and can be purchased at the cafe, or via the form below.

Note: Ticket cost is to cover the food and therefore are non-refundable

The post Hormone Health and Food Talk appeared first on Alison Mitchell Naturopath.