Endocrinology is the field of medicine that deals with hormones. Hormones are substances produced in one part of the body and exert an influence in the function or activity of another part of the body. Among other things, hormones regulate digestion and metabolism, blood pressure, heart rate, and the body's response to stress. Reproductive endocrinology is the subspecialty of endocrinology that deals specifically with those hormones responsible for sexual and reproductive function.
Hormones and Reproduction
Certain hormones that fall under the reproductive endocrinology subspecialty are produced by the reproductive organs themselves, such as estrogen, progesterone, and testosterone, which are produced by the ovaries and testicles. Other hormones that control the function of the reproductive organs are actually produced far from the reproductive organs. For example, follicle-stimulating hormone and luteinizing hormone are produced by the pituitary, a hormone-producing organ located at the base of the brain.
Background and Training
In practice, the field of reproductive endocrinology is typically combined with infertility: “reproductive endocrinology and infertility,” or REI for short. Unlike general endocrinologists, reproductive endocrinologists do not base their training in general internal medicine, but in obstetrics and gynecology. In the United States, after completing medical school, reproductive endocrinologists complete a four-year residency in all aspects of obstetrics and gynecology, including general and high-risk obstetrics, labor and delivery, gynecologic surgery, and gynecologic cancer. Then they complete a three-year subspecialty fellowship specifically in reproductive endocrinology and infertility.
Scope of Expertise
The majority of patients cared for by a reproductive endocrinologist are interested in achieving a healthy pregnancy. These include patients with problems such as age-related infertility, dysfunction of the ovaries or ovulation, blocked or abnormal fallopian tubes, low sperm count or other sperm issues, endometriosis, and inherited or genetic diseases that they hope to avoid passing to their offspring. In couples who have a significant issue related to sperm or some other problem related specifically to the male partner, a reproductive endocrinologist usually collaborates with a urologist who specializes in male fertility issues. Typical treatments include fertility medications; intrauterine insemination, also known as "artificial insemination"; and in vitro fertilization. Many women hoping to achieve a healthy pregnancy also require surgical treatment for conditions such as uterine fibroids and endometriosis.
Many reproductive endocrinologists also care for patients who are not interested in getting pregnant but who have problems relating specifically to the reproductive hormones. These can include patients with polycystic ovarian syndrome, endometriosis, menopause-related problems, sexual dysfunction and abnormal sexual development.