Female

Polycystic Ovary Syndrome (PCOS)

PCOS is a condition where the ovaries produce too much of the male hormones called androgens. It affects 7-10% of reproductive aged women making it the most common hormonal disorder among women of childbearing age. It is often inherited. PCOS causes multiple small follicles to grow in the ovaries and, as a result, women with this condition typically do not ovulate regularly. In addition to having irregular periods, women with PCOS are more likely to have insulin resistance and may develop type 2 diabetes and high blood pressure.

Common Symptoms:
• Irregular or absent menstrual cycles
• Infertility
• Excess body or facial hair (hirsutism)
• Acne
• Thinning scalp hair
• Weight gain

Diagnosis:
Your endocrinologist may perform a number of tests before making a diagnosis of PCOS. These may include:

• Medical History
• Physical Exam
• Blood tests to measure hormone levels- high androgen levels are common in patients with PCOS
• Ultrasound examination of the ovaries
• Diabetes screening

Treatment:
PCOS is not curable but symptoms can be alleviated through medication as well as changes in diet and exercise. Your doctor will recommend treatments that best fit your symptoms. These treatment options may include
• Diet and Exercise: Your doctor may recommend diet and lifestyle changes to help manage diabetes and high blood pressure. For patients who are overweight, losing weight loss can help to make periods more regular and reduce hair growth.
• Oral contraceptives: Oral contraceptives (birth control pills) may be prescribed to regulate menstrual periods and treat hirsutism and acne by lowering testosterone levels.
• Metformin: Metformin is a medication commonly used to treat type 2 diabetes. Your doctor may prescribe metformin to reduce insulin resistance, decrease testosterone levels, and improve ovulation
• Spironolactone: This is a medication that blocks the effect of testosterone on the hair follicles and sebaceous glands and thus helps to improve acne and hirsutism.
• Aesthetic Methods: Your doctor may prescribe certain creams or recommend laser treatments or electrolysis to manage excessive hair growth.
• Ovulation Induction: Our physicians have extensive expertise in helping women with PCOS to get pregnant using oral medications such as clomiphene or injection therapy with gonadotropins.

FAQS:
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Helpful references:
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Menopause

Menopause is the time in a woman’s life where her periods end and the production of the hormones estrogen and progesterone declines.

Symptoms:
• Infrequent or absent menstrual periods
• Hot flashes
• Night sweats
• Poor concentration
• Memory loss
• Vaginal dryness
• Weight gain
• Depression

Diagnosis:

• Medical History
• Physical Exam
• Blood test to look at hormone levels: A high FSH is indicative of the onset of menopause

Treatment:
The symptoms of menopause can be alleviated through both hormonal and non-hormonal therapies. Your doctor will discuss the risks and benefits of these medications with you and decide if they are appropriate for you. These therapies may include:

• Estrogen replacement therapy: Estrogen replacement therapy may be prescribed by your doctor to provide your body with the estrogen it no longer produces. This may be prescribed on its own to women who have had a hysterectomy (no uterus)
• Combined estrogen-progesterone replacement therapy: A combined estrogen-progesterone replacement therapy may be prescribed to relieve menopausal symptoms in women who still have a uterus.
• Selective serotonin reuptake inhibitors: Some medications used to treat depression are also effective in reducing both the frequency and severity of hot flashes.

Helpful Links:
» Hormone.org

 

Premature Ovarian Insufficiency

Premature Ovarian Insufficiency (POI)

POI is a condition where a woman’s ovaries stop working before the age of 40. About 1% of women in the United States have POI and of these, 10-20% will have a family member with this condition. Women with POI do not produce normal amounts of estrogen and do not ovulate regularly. A number of different conditions can cause POI including chromosomal abnormalities such as Turner syndrome, exposure to toxins such as chemotherapy or radiation and an autoimmune disorder where the body makes antibodies that damage the ovaries. However, in many cases the exact cause of POI may not be identified.

Symptoms:
• Irregular or absent menstrual periods
• Infertility
• Night sweats
• Vaginal dryness
• Decreased sex drive
• Irritability
• Depression/ anxiety
• Poor concentration
• Memory loss
• Decreased bone density

Diagnosis:
Your endocrinologist will perform multiple tests before confirming a diagnosis of POI. These may include:
• Medical History
• Physical Exam
• Blood test to look at hormone levels: An abnormally high FSH level could be indicative of POI
• Ultrasound examination of the ovaries
• Karyotype: to rule out any chromosomal abnormalities
• DEXA Scan: Similar to an X-Ray. A DEXA scan measures bone density

Treatment:
POI is not curable but symptoms can be alleviated through medications. Your doctor will recommend treatments that best cater to your symptoms. These treatment options may include
• Hormone therapy: Hormone therapy may be prescribed by your doctor to replace the estrogen and progesterone your body is no longer producing.
• Calcium and Vitamin D supplements: To help reduce the risk of osteoporosis your doctor may recommend you take calcium and vitamin D supplements.

FAQS:
Helpful Links:
» NICHD
» Hormone.org

 

Hypothalamic Amenorrhea

Hypothalamic amenorrhea (HA) is a condition that occurs when the brain slows or stops its production of gonadotropin releasing hormone (GnRH). The term amenorrhea refers to an absence of menstrual periods. There are two types of hypothalamic amenorrhea:

Primary Amenorrhea: Characterized by an absence of puberty. Women with primary amenorrhea have had no period by the age of 16 or within 5 years of the first signs of puberty. This condition is usually due to a genetic or organ defect.
Secondary Amenorrhea: A condition where a woman had been having normal periods but then stops having them for at least 3 months. Secondary amenorrhea is more common than primary amenorrhea and can be caused by factors such as weight loss, stress, or over exercising. In most of these cases monthly cycles will be restored once stress levels are reduced and weight returns to normal.

Common symptoms:

Primary amenorrhea- Symptoms of primary amenorrhea include absent periods or no signs of puberty by the age of 16

Secondary amenorrhea: Symptoms of secondary amenorrhea include absent periods for at least 3 months and vaginal dryness.

Diagnosis:
Your endocrinologist will perform multiple tests before confirming a diagnosis of HA. These may include:
• Medical history
• Physical exam
• Pregnancy test
• Blood test to check hormone levels- low LH, FSH, and estrogen levels can suggest HA
• MRI of the pituitary gland

Treatment:
Your doctor will suggest treatment options to best fit your symptoms.
• Oral Contraceptives (OCPs): OCPs that combine estrogen and progesterone will help balance the body’s hormone levels.
• Vitamin D and Calcium supplements: Patients with amenorrhea may be at risk for bone loss. Your doctor may recommend taking vitamin D or calcium supplements.
Secondary Amenorrhea
• Oral Contraceptives (OCPs): OCPs that combine estrogen and progesterone will help balance the body’s hormone levels.
• Vitamin D and Calcium supplements: Patients with amenorrhea may be at risk for bone loss. Your doctor may recommend taking vitamin D or calcium supplements.
• Lifestyle changes: Your doctor may recommend lifestyle changes including decreasing your stress as well as altering eating and exercise habits.

FAQ
» Hormone.org

 

Procedures

Ovulation Induction

Ovulation induction is a procedure in which medication is used to stimulate the development of one or more follicles in the ovaries in women who are having trouble getting pregnant. These medications can be taken by mouth (clomiphene) or by injection (gonadotropins).

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Ultrasound

Ultrasound is a type of imaging that produces pictures of the inside of the body using sound waves. A pelvic ultrasound provides pictures of organs and structures in the lower abdomen. In women, transabdominal and transvaginal ultrasounds are a useful tool to look at reproductive structures such as the uterus, cervix, ovaries, and fallopian tubes. If you’re pregnant an ultrasound is performed routinely to ensure the health and safety of the growing fetus. There are two types of pelvic ultrasounds:
• Transabdominal: An ultrasound where the transducer, a small handheld device, is moved back and forth across the lower abdomen
• Transvaginal: The transducer is placed into the vagina and the ultrasonographer will move the probe around to look at different areas of the pelvic region