Menstrual and Reproductive Issues

  • PCOS/Polycystic Ovarian syndrome:

    A common condition in young women leading to menstrual irregularities, acne, excessive facial and/or body hair, infertility issues.

  • Reproductive endocrinology:

    Management along with reproductive specialists for fertility issues.

  • Post menopausal hormone replacement:

    Treatment for symptoms of hot flashes, mood changes, vaginal dryness, etc. in postmenopausal women.

  • Hypogonadism:

    Low or Testosterone deficiency in men leading to decreased Libido, Erectile dysfunction, low moods, loss of muscle mass etc.

menstrual and reproductive issues- Reliant endocrinology

Polycystic ovary syndrome (PCOS) is a hormonal problem in which abnormally excess levels of androgens (male hormones that are present in small amounts in women) are produced by the ovaries, resulting in an imbalance of reproductive hormones. As a result, ovaries develop fluid-filled sacs or small cysts, due to which ovaries fail to release eggs regularly (anovulation). PCOS affects women of reproductive age (15 to 44 years old). About 70% of women don’t know they have PCOS [1].

PCOS is characterized by excess hair growth, acne, increased androgen levels, obesity, and menstrual cycle abnormalities. Women with PCOS have a higher chance of pregnancy-induced high blood pressure, premature delivery, gestational diabetes, preeclampsia, and miscarriage.

What exactly causes PCOS is not known. Doctors believe that unusually high levels of androgens make it difficult for the ovaries to produce eggs. The following are some factors that contribute to PCOS:

1. Heredity: Research has shown that certain genes, not one, contribute to PCOS. These genes cause PCOS to run in families [2].

2. Low-Grade Inflammation: Women with PCOS have low-grade inflammation that stimulates the ovaries to produce abnormal androgen levels.

3. Insulin Resistance: Studies have shown excess insulin levels in 70% of women with PCOS. Insulin resistance increases androgen production that causes difficulty with ovulation [3].

Common symptoms of PCOS include:

  • Male pattern baldness
  • Weight gain
  • Darkening of the skin
  • Excess body hair
  • Acne breakouts and oily skin
  • Polycystic ovaries
  • Irregular periods, missed periods, heavy periods

PCOS-related abnormally high levels of androgens not only cause fertility problems but also affect other aspects of health. Some complications of PCOS include:

  • Depression, anxiety
  • Eating disorders
  • Sleep apnea
  • Infertility
  • Type 2 diabetes or prediabetes
  • Abnormal uterine bleeding
  • Premature birth or miscarriage
  • Metabolic syndrome
  • Endometrial cancer

If you have at least two of the following symptoms, you have PCOS:

  • Cysts in the ovaries
  • Irregular menstruation
  • High androgen levels

To diagnose PCOS, your doctor also performs a pelvic exam, during which growths in ovaries or uterus are checked by inserting gloved fingers in the vagina.

If PCOS is caused by some health conditions, the following tests are recommended:

  • Blood tests to look for high levels of androgens.
  • Ultrasound to look at the size of ovaries and cysts present in them.

Treatment options for PCOS depend on the age, severity of symptoms, and overall health.

1. Medications: Medications can restore hormonal balance, help ovaries to release the eggs normally, and relieve symptoms like excess body growth.

2. Lifestyle Changes: Eating healthy and engaging in physical activity can help you lose weight, a major contributor to PCOS symptoms. A healthy diet can help you ovulate regularly and regulate your blood glucose and insulin.

Your chance of having gestational diabetes, miscarriage, premature delivery, and pregnancy-induced high blood pressure increases if you have PCOS. PCOS occurs when you have abnormally high levels of androgens produced by the ovaries. In women with PCOS, hormonal balance interferes with ovulation, causing infertility concerns.

Dr. Bakerywala (endocrinologist) understands that besides medical therapy most long standing endocrine disorders have to be managed with several other key interventions like education, lifestyle changes and counseling. Located in tri state area with patients from the following areas: Wyckoff, Franklin Lakes, Fair Lawn, Oakland, Ridgewood, Wayne, Glen Rock, Paramus, Hackensack, Clifton, Edgewater, Elmwood Park, Mahwah, Allendale, Passaic county NJ, rockland county NY, Suffern NY, Nyack NY and other areas across New Jersey and New York.