The endocrine system is a complex network of organs and hormones that communicate with each other and other parts of your body to perform various functions. One of these functions is reproduction. Many disorders of the endocrine system have the potential to impact fertility, including conditions that aren’t directly related to reproduction, such as diabetes or thyroid disease.
Reproductive endocrinology requires advanced training beyond general fertility medicine. Currently undertaking this intensive subspeciality training to become a Certified Reproductive Endocrinology and Infertility (CREI) specialist, Dr Kate has the skills and expertise to manage the complex hormonal causes that often underlie both male and female infertility.
A typical menstrual period occurs every 28 days on average and lasts for approximately five to seven days. This marks the time where a woman’s body sheds the lining of the uterus if no pregnancy occurs that month. Menstrual disorders encompass a range of abnormalities, including unusually heavy periods, a lack of periods, irregular periods, severely painful periods, premenstrual syndrome, and premenstrual dysphoric disorder.
Though there may be other causes of menstrual disturbances, such as uterine fibroids or infection causing heavy bleeding, many of these disorders are caused by a hormone issue.
Endometriosis occurs when the tissues lining the uterus grow elsewhere in the body, including the ovaries, pelvis, and fallopian tubes. This tissue is primed to respond to a woman’s monthly cycle of hormones, which means when her menstrual period is due, these tissues outside the uterus also break down and bleed. However, because of their abnormal location, the tissue byproducts result in chronic inflammation, scarring, and adhesion. In addition to causing significant pain and heavy menstrual bleeding, endometriosis can cause infertility in up to 50% of women affected with this condition.
Management of endometriosis is complex and may require hormone based therapies, physiotherapy or laparoscopy surgery to remove the abnormal endometrial tissue.
PCOS is a common hormonal condition caused by the production of abnormally high levels of androgens (male hormones). In addition to disrupting normal menstruation, these hormones are associated with symptoms such as unwanted hair growth, acne, and infertility. Women with PCOS are also at a higher risk of diabetes and other complications.
Individual symptoms of PCOS may be treated with specific therapies, such as laser hair removal for unwanted hair growth or topical skin treatments for acne. However, to manage the underlying hormonal dysfunction, hormone therapies such as the contraceptive pill may be necessary. Treatment will depend on whether the goal is to manage the symptoms of PCOS or to achieve a pregnancy. Many people with PCOS will not ovulate regularly and may require assistance in order to conceive,
This cause of male infertility is characterised by low testosterone level, which interferes with sperm production. Hypogonadotropic hypogonadism can be due to a genetic disorder known as Kallmann syndrome, or can develop due to dysfunction of the pituitary gland, such as from a tumour or surgery. Treating this condition may require the use of replacement hormones in order to allow normal sperm production.
