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. Many couples or individuals facing infertility problems choose to see a reproductive endocrinologist. This highly skilled professional can identify factors that may be causing infertility and work with patients to select appropriate methods of treatment.
Imbalances of Reproductive Hormones
An imbalance of reproductive hormones can cause not only infertility problems, but other serious medical issues. A reproductive endocrinologist can identify both, as well as investigating changes in hormone levels over time, or problems in the hypothalamus or pituitary gland, where these hormones are produced. Hormone levels are evaluated through blood tests, urinalysis and analysis of semen. These tests help to identify a wide range of other physical problems caused by these abnormal or fluctuating levels of reproductive hormones that may include:
- Mood swings
- Metabolic abnormalities
- Sexual dysfunction
- Menopausal symptoms
- Low sperm count
- Menstrual abnormalities
- Ovulation problems
- Polycystic ovary syndrome
- Recurrent miscarriages
Reproductive Endocrinology Treatments
Reproductive endocrinology treatments focus on correcting hormonal imbalances at the root of many health and fertility issues. Reproductive endocrinologists can assist patients with a number of conditions, both to increase fertility and to restore health and well-being.
Ovulation induction is a process designed to increase the chances of conception by stimulating egg production. To this end, patients are administered hormones, either orally, or through injection. Ovulation induction is used to increase fertility using a variety of reproductive methods, including sexual intercourse, intrauterine insemination, in vitro fertilization, gestational surrogacy or other assisted reproductive technologies.
Irregular menstruation, abnormal uterine bleeding, or progesterone problems can also be treated by administration of hormones. Diagnostic tests are used to determine whether hormones alone will be helpful, or whether other treatment methods, such as surgery, may be necessary. Birth control pills are commonly prescribed to treat menstrual irregularities. Other medications may be prescribed to trigger a menstrual period or to regularize the menstrual cycle.
Polycystic Ovary Syndrome
Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder among women in their reproductive years. Caused by an imbalance of hormones in the ovaries, it is characterized by a chronic inability to ovulate and elevated male hormones. Symptoms include infrequent or absent ovulation or menstrual 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 3 months of treatment.
Every woman goes through menopause as her body begins to produce less estrogen and her menstrual cycle stops, typically sometime after the age of 50. Menopause may also be triggered prematurely by surgery to remove the ovaries, or cancer treatments, like chemotherapy and radiation. Some women go into early menopause for no known reason.
The reproductive endocrinologist can determine whether a woman is going through menopause by checking hormone levels in her blood or urine. There are a variety of treatment options to relieve the symptoms of menopause, including hormone replacement therapy (HRT), dietary changes, and alternative treatments. Hormone replacement therapy involves taking the hormones estrogen and progesterone. Because HRT carries some serious risks, patients should carefully evaluate the plan with their physicians before beginning treatment.
Other Hormone Irregularities
Reproductive endocrinologists are also able to treat other conditions either related to hormone imbalances or controlled through hormone administration. These professionals may prescribe and monitor hormones to treat fibroids, Cushing's syndrome, thyroid dysfunction and other conditions in which hormones play a significant role.
Consultation with a reproductive endocrinologist can be a valuable first step towards treatment of fertility issues. Based on a thorough evaluation of patient health, in terms of possible hormone imbalances and other fertility issues, a reproductive endocrinologist is able to help determine the best diagnostic and treatment.