Reproductive Endocrinology
Treating Reproductive Conditions
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting young women. This condition is associated with infertility, absent or irregular menstrual cycle and increased activity of testosterone (“male hormone”). Most women with PCOS have also other hormonal and metabolic problems such as elevated level of insulin and cholesterol. In the long term, women with this condition are at increased risk of cardiovascular diseases and diabetes. Our center offers extensive state-of-the-art testing and treatments of PCOS. We are also developing new therapies designed to treat symptoms and to protect from long-term consequences of this disorder.
Hyperprolactinemia
Hyperprolactinemia is a hypothalamic-pituitary condition of elevated serum prolactin in non-pregnant women. Hyperprolactinemia may affect menstrual cycle and ovulation. It may also cause infertility and loss of libido. On occasions hyperprolactinemia may be caused by a small tumor in the pituitary and may damage the surrounding organs such as the optic nerves. Therefore, the timely diagnosis and treatment of hyperprolactinemia is quite important. Our practice collaborates with Medical Endocrinology Pituitary Program and Neurosurgery together offering state-of-the-art testing and treatments for hyperprolactinemia.
Pituitary/Hypothalamic Failure
The anterior (front) lobe of the pituitary gland makes up 80 percent of the gland's weight. It releases a variety of hormones that affect growth, physical and sexual development, and other endocrine glands. Oversecretion or undersecretion of certain hormones by the anterior lobe of the pituitary gland will cause other endocrine glands to over- or underproduce certain hormones, as well. More
Thyroid and Adrenal disease
There are many disorders of the thyroid that require clinical care by a physician or other healthcare professional.
More Disorders of the Thyroid
Disorders of the Adrenal Gland
Hyperandrogenism
Hyperandrogenism is the detection of excess androgen (a masculine steroid hormone). The most common clinical presentation of hyperandrogenism in reproductive-aged women is acne or hirsutism.
ACNE
Acne is a disorder of the hair follicles and sebaceous glands. The glands become clogged, leading to pimples and cysts. Acne is very common - nearly 17 million people in the US are affected by this condition. Acne most often begins in puberty. During puberty, the male sex hormones (androgens) increase in both boys and girls, causing the sebaceous glands to become more active - resulting in increased production of oil (sebum). More
HIRSUTISM (Excessive Hair Growth)
Excessive hairiness, also known as hirsutism, is characterized by abnormal hair growth on areas of skin that are not normally hairy. Although the condition can affect both men and women, it usually only presents a problem to women. More
Ovulatory Disorders
Ovulatory disorders are common in reproductive age women and constitute the most common cause of menstrual abnormalities. In addition to causing discomfort due to irregular bleeding, ovulatory disorders are also common causes of infertility.
Ovulatory disorders may result from problems in the ovary as well as abnormalities in the pituitary gland and hypothalamus in the brain. Another common cause of ovulatory dysfunction associated with hirsutism is polycystic ovary syndrome.
Yale Reproductive Endocrinology offers state-of-the-art approaches for the diagnosis of underlying causes of ovulatory disorders as well as their treatment. Experts at Yale Reproductive Endocrinology are recognized nationally and internationally for their scientific contributions in the pathogenesis, diagnosis and treatment of ovulatory disorders and authored many peer reviewed articles.
Hormone Imbalance
Hormonal imbalance may be caused by abnormalities in the secretion of estrogen, progesterone, as well as androgens. Depending on the type of abnormality, patients may experience a wide array of symptoms, including hot flushes, vaginal dryness, depression, abnormal vaginal bleeding, and excessive hair growth. Our practice offers a wide array of tests depending on patients' needs and state-of-the-art treatment.
Irregular Abnormal Uterine Bleeding
Every year approximately 180,000 women in the United States undergo hysterectomies for treatment of abnormal uterine bleeding. And many more women with this condition forego hysterectomies and either suffer silently or rely on relatively ineffective hormonal treatment. But Yale Reproductive Endocrinology has expertise with a number of alternative outpatient or office-based surgical procedures that offer relief, including endometrial cryoablation and thermal ablation.
Uterine Fibroids
Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 30 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 75 percent of women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a physician during a physical examination. More
Pelvic Pain (including painful menses and/or painful intercourse; “dyspareunia”)
Pelvic pain is a common complaint among women. Its nature and intensity may fluctuate, and its cause is often obscure. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, lasting over a period of months or longer. Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present. More
Endometriosis
Endometriosis is defined as the presence of endometrial tissue (inner uterine lining) outside of the uterus. This disorder affects approximately 10% of women in their reproductive years, and may be found in up to 40% of women with infertility. Endometriosis often results in painful periods, pain at intercourse, pelvic scarring and/or decreased fertility. Although such symptoms may suggest its presence, the diagnosis can only be confirmed surgically. At Yale Reproductive Endocrinology, we offer state of the art diagnosis and therapy for endometriosis. Our staff has extensive experience with all aspects of this disorder, including minimally invasive laser surgery, hormonal suppressions and advanced reproductive technologies. More
First Trimester Recurrent Pregnancy Loss
70% of the women who miscarry one or two times can expect to go on to carry a child to full term. But for those who experience three or more miscarriages, diagnostic testing and possible treatment are needed to determine the cause. Miscarriages can have multiple causes. Most common causes of repetitive miscarriages include autoimmune problems, genetic problems, anatomic problems, and hormonal problems. A number of tests are used to determine the reasons for multiple miscarriages. These include chromosomal analysis of both partners, examinations of the uterine cavity via ultrasound, immunologic testing, and hormonal testing. The Recurrent Pregnancy Loss Program at Yale Reproductive Endocrinology has a multi-disciplinary team approach. The program allows the patient to be treated more completely. Comprehensive assessment and treatment plan designed by the input of a multi-disciplinary team including perinatologists, pathologists and psychologists together with reproductive specialists allows a broad assessment of each patient. More
Perimenopausal and Menopausal Therapy Program
Although the age of menopause has not changed in several hundred years, the life expectancy of women has nearly doubled in the 20th century. Today women in developed countries live approximately 1/3 of their lives in menopause. Menopause is defined by the lack of estrogen. Estrogen loss causes many problems as one enters this stage of life. Estrogen is known to have effects on the heart, bone, brain, skin and other organs.
The Yale Reproductive Endocrinology Menopausal Therapy Program offers counseling, testing and intervention to proactively address multiple issues associated with menopause, including cardiovascular disease, osteoporosis, effects of estrogen deprivation on the brain (hot flushes, mood changes, sleep disturbances), skin and other organs. We offer counseling as to the risks and benefits of hormone replacement and discussion of alternatives.
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