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Reproductive endocrinology is a field of medicine specialized in any hormonal problems affecting the ovaries in women and the testes in men.
In women, the common issues within this subspecialty are PCOS, perimenopause and postmenopausal syndrome as well as many causes of irregular periods. In men, low testosterone or decreased sperm production at any age is evaluated by a reproductive endocrinologist.
While most OB/GYN-REI specialists are focused in the infertility component of this field, Dr. Glueck has expertise in the overall treatment of reproductive hormonal dysfunction in both men and women.
Although common, PCOS can be challenging to diagnose particularly for physicians who do not focus in this problem. Simply put, PCOS is a hormone problem that involves higher testosterone hormones from the ovary (called androgens) and heightened insulin resistance. In women, the effect of extra testosterone can cause irregular periods, acne, extra hair growth (hirsutism) and/or hair thinning on the scalp (alopecia). Insulin resistance can cause difficulty with weight loss and increased risk of type 2 diabetes.
For women, there is a "fifth vital sign". Along with blood pressure, temperature, heart rate and respiratory rate, menstrual irregularities can indicate a variety of hormonal imbalances, gynecologic problems, infections, acute stress or lifestyle changes.
Common hormone issues that cause irregular periods (absent periods, skipping periods or even heavy periods) are PCOS, ovarian insufficiency (either early or normal perimenopause/menopause), pituitary problems including high prolactin hormone, thyroid dysfunction and weight disorders. Both high weight and low weight can disrupt regular periods through pituitary dysfunction.
Every woman progresses through perimenopause and menopause in a different way. The symptoms of menopause are extremely varied and can be very debilitating. The majority of women who are close to their menopause are good candidates for hormone replacement therapy with FDA approved medications using either estrogen alone or estrogen in combination with progesterone. The decision whether or not to use hormone replacement therapy needs to be made carefully with the risks and benefits of therapy discussed in detail with highly individualized care.
Testosterone is an extremely important hormone in men, not only for sexual health and sperm production but also crucial for cardiovascular protection and bone health. The diagnosis and particular cause of a low testosterone level should be thoroughly evaluated before treatment is started.
PCOS is a complex issue that is often difficult to diagnose and confusing to read about. In a research study about the experience of women seeking help for PCOS symptoms, nearly half of women had to see at least 3 health care professionals before a PCOS diagnosis was established and only 15% of those patients diagnosed with PCOS were satisfied with the information about PCOS provided at the time of diagnosis. Lets change that.
Particularly in young men, a finding of low testosterone is extremely uncommon. Low testosterone can reflect serious underlying medical problems including:
• Pituitary diseases and tumors
• Kidney, liver or heart failure
• Medications and drug use
• Obesity and malnutrition
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