Introduction:
The objectives are to discuss the cyclic changes in hypothalamic, pituitary, and ovarian hormones and other growth factors in the menstrual cycle. This is a medical specialty for infertility, menopause, and other issues with reproductive hormones. Reproductive endocrinologists are obstetrics and gynecology physicians with specialized training regarding reproductive hormone problems in men and women. The specialty is defined as reproductive endocrinology and infertility because it mainly focuses on helping women to conceive and carry a baby.
What is Reproductive Endocrinology?
The hormones and control systems that regulate sexual maturation, sexual function, and reproduction are covered within the field of reproductive endocrinology. A wide range of symptoms, such as infertility, hirsutism, virilization, oligomenorrhea, and amenorrhea in women, and infertility and altered sexual function in men, can be present in disorders of reproductive endocrinology. These abnormal changes can occur anywhere along the hypothalamus-pituitary-gonadal axis.
What Is the Classification of Hormones?
The hormones are peptide hormones, amino acid derivatives, and steroid hormones.
-
Steroid Hormones: Progesterone, testosterone, and estrogen.
-
Amine Hormones: Thyroxine and adrenaline.
-
Peptide Hormones: Insulin.
The pituitary gland secretes sex and reproductive hormones, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).
Follicle-stimulating hormone (FSH) is necessary for egg and sperm production.
LH stimulates the ovaries, testes, and the uterus (womb) to implant a fertilized embryo.
Testosterone is released from the testes and is necessary for sperm production and developing secondary sexual characteristics.
Estrogen: This hormone is released from ovaries and is necessary for egg production and uterus(womb) preparation so that it helps to implant the fertilized embryo and the development of secondary sexual characteristics.
Male Reproductive System:
When fertilization, the sperm with either an X or a Y chromosome determines sex by fusing with an X-bearing ovum. At seven weeks of gestation, there is a possibility of sex determination.46, XY gonad becomes testis, and 46, XX gonad remains as an ovary.
-
The testes and epididymis help in sperm production and maturation.
-
Seminovesical, prostate, and bulbourethral glands produce nutrient-rich seminal fluid.
-
Testes produce sperm and hormones.
-
The scrotum holds the testicles outside of the body.
-
The prostate gland produces nutrients rich fluid to feed and protect the sperm.
Development of External Genitalia:
-
The di hydro testosterone (DHT) causes the development of the external male structures before birth. That is the labioscrotal swelling, urethral folds, and glans area.
-
The absence of DHT results in the development of the female.
What Changes Occur Due to Elevated Levels of Androgens at Puberty?
-
Skeletal muscle growth.
-
There is lengthening and development of the larynx or deepening of the voice.
-
Pubic hair and beard growth.
-
Sebaceous gland activity and odorous sweating.
-
There is thickened and pigmented skin over the external genitalia.
-
Increase the size of the prostate gland.
-
Epiphyseal fusion and termination of the linear growth.
The disturbance in normal functioning in the male reproductive system is increased breast tissue in men (gynecomastia) and reduced testosterone production hypogonadism.
Female Reproductive System:
-
The ovaries produce eggs and hormones.
-
The uterus accommodates the developing fetus, and the uterus lining builds up monthly.
-
Fallopian tubes or oviducts help transport eggs from the ovaries to the uterus.
-
The cervix is the uterine opening, which dilates during the baby's delivery.
-
The vagina is the birth canal of the fetus.
The endocrine disorders in the female reproductive system are irregular menstrual periods, polycystic ovary syndrome, hirsutism (abnormal hair growth on a woman's face and body), and premature ovarian failure.
In What Conditions Is There a Need for a Reproductive Endocrinologist?
A reproductive endocrinologist is needed for any condition related to female hormones. The conditions include the following:
1. Infertility:
When the woman cannot conceive for a long time, the reproductive endocrinologist asks questions and recommend tests to know the cause of infertility. The doctor then suggests treatments based on the cause.
2. Fertility Preservation:
There is a possibility of preservation of the sperm, eggs, or the fertilized egg (fetus) when a condition, treatment, or experience affects fertility. For example, women who undergo cancer treatment or chemotherapies can decide to keep their eggs or embryos frozen before the treatment.
3. Frequent Miscarriages:
The women can conceive but cannot have a viable pregnancy and have difficulty carrying the fetus to full term.
4. Endometriosis:
Endometriosis is the lining that lines the uterus, builds up inside the woman's uterus (womb), and is present in other places outside the uterus. The woman's hormones try to eliminate the uterus lining during the menstrual period. In women with endometriosis, there is severe pain during the menstrual period as there is an expulsion of the lining cells inside and outside the uterus.
5. Menstrual Problems:
Women who have irregular or heavy periods or do not get periods at puberty.
6. Menopause:
Menopause means the stoppage of the menstrual period, which occurs at the age of forty-five to fifty. Therefore, there is a need for reproductive endocrinologist consultation to help women deal with the hormonal alterations that occur with menopause and to consider hormone replacement procedures.
7. Sexual Development:
Some need hormonal treatment for their sexual development. Hence there is a need for reproductive endocrinologists.
What Are the Treatment Procedures Which the Reproductive Endocrinologist Suggests?
Reproductive endocrinologists suggest several treatments for reproductive problems, and they are as follows:
1. Assisted Reproductive Technology That Includes in Vitro Fertilization:
Assisted reproductive technology is a procedure in which the eggs and fertilization of eggs with sperm is done outside the women’s body. The most common procedure is in vitro fertilization (IVF). First, the physicians remove eggs from a woman's uterus and a sperm sample from the woman’s partner or a donor. Next, eggs are fertilized outside a woman’s body in a lab. A fertilized egg is then implanted for further growth in the mother's uterus.
2. Gynecological Surgeries:
Reproductive endocrinologists perform surgeries to remove uterine fibroids (noncancerous overgrowths in the uterus), identify and manage endometriosis, surgery to remove any blocked fallopian tube (the tube that carries eggs from from the ovaries to the uterus), or address any other barrier to getting pregnant.
-
Hormone Treatments:
Hormones are utilized along with assisted reproductive technology to manage infertility or to help the women carry the fetus to full term. In addition, hormones are also utilized to manage certain causes of infertility, like polycystic ovarian syndrome.
Conclusion:
Reproductive endocrinology is a special study that includes all the issues related to reproductive hormones. The obstetric gynecologist undergoes specialized training in hormones and infertility. They also thoroughly know how reproductive hormones affect fertility and overall health. Therefore, there is a need to consult a reproductive endocrinologist if there are irregular periods and fertility-related issues.
