Reproductive endocrinology is a subspecialty of obstetrics and gynecology that addresses hormonal functioning as it relates to reproduction and infertility. In addition to treating infertility issues, reproductive endocrinologists are trained to evaluate and treat other hormonal dysfunctions in females and males. Many couples facing infertility problems choose to see a reproductive endocrinologist when deciding upon fertility treatments. A reproductive endocrinologist can help to diagnose conditions and identify factors that may be causing infertility, and work with patients to select the appropriate methods of treatment.
A reproductive endocrinologist can identify infertility problems caused by an imbalance of reproductive hormones, changes in the hormone levels over time, or problems in the hypothalamus or pituitary gland, where the hormones are produced. These hormone levels can be evaluated through blood tests, urine analysis and semen analysis. These tests can help to identify a range of other physical problems caused by these hormones that may include:
- Mood swings
- Weight gain
- Sexual dysfunction
Reproductive Endocrinology Treatments
Reproductive endocrinology treatments focus on correcting hormonal imbalances which may lead to health and fertility issues. A reproductive endocrinologist may also use hormone therapy to enhance fertility and address other medical conditions.
With ovulation induction, doses of hormone treatments are given to stimulate egg production and make ovulation more predictable. Either oral or injectable hormone treatments are used. Ovulation induction may be used with sexual intercourse, intrauterine insemination, in vitro fertilization, gestational surrogacy or other assisted reproductive technologies.
Irregular menstruation, abnormal uterine bleeding, or progesterone problems may be treated with hormones. Tests will determine whether hormones or other treatment methods, such as surgery, are appropriate. Birth control pills are commonly prescribed to treat menstrual irregularities. Progestin may be prescribed to trigger periods and clomid may be prescribed to women with irregular periods who wish to get pregnant.
Polycystic Ovary Syndrome
Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder among reproductive-age women. It is characterized by a chronic inability to ovulate and elevated male hormones resulting from an imbalance of hormones in the ovaries. Symptoms include infrequent or absent ovulation or periods, excess facial or body hair, male pattern baldness, acne and infertility. Treatment of PCOS helps to manage symptoms and improve fertility. Low doses of clomiphene may be given to stimulate ovulation, or gonadotropin hormones may be administered by injection. Most patients are able to ovulate after about three months of treatment.
Menopause affects every woman, as their body begins to produce less estrogen and the menstruation cycle stops. This typically begins for most women over the age of 50. Menopause may also be triggered prematurely by surgery to remove the ovaries or cancer treatments such as chemotherapy and radiation. The reproductive endocrinologist can confirm menopause by checking hormone levels in the blood or urine. There are a variety of treatment options for menopause, including hormone replacement therapy, diet and alternative treatments. Hormone replacement therapy involves taking the hormones estrogen and progesterone.
Fibroids, polyps, cancer, Cushing's syndrome, thyroid dysfunction and other conditions may also be treated by hormone therapy. In each case, the physician will determine the best method of treatment.
Consultation with a reproductive endocrinologist can be a valuable first step towards treatment of fertility issues. A reproductive endocrinologist will determine the best diagnostic and treatment options, based on a thorough evaluation of the patient's overall health and fertility issues.