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Male- and Female-Specific Endocrinology

Part of what endocrinologists study, and what part of what defines their field of care, are the special roles of hormones in women and in men. Some hormone functions are common to both sexes while other take highly gender-specific forms.

Endocrinologists may work with gynecologists, andrologists (urologists focusing on the male reproductive system) or fertility specialists on hormonal conditions specific to men or women.
Women

Female endocrinology has to do largely with the reproductive cycle driven by estrogen and other cyclical female hormones. Related issues that the endocrinologist may help evaluate and provide care for include:

  • early or delayed menarche;
  • menstrual irregularity;
  • heavy, light or absent menses;
  • premenstrual syndrome;
  • abnormalities that may produce symptoms that cycle with menses, such as ovarian cysts or uterine fibroids;
  • perimenopause;
  • menopause;
  • endocrine-related depression, fatigue or reduced sex drive;
  • and hormone replacement therapy.

Endocrinologists help determine any hormonal irregularities that may contribute to or worsen these conditions and sometimes provide medical interventions, including those that increase or decrease hormonal stimulation. The endocrinologist may work closely with the gynecologist, gynecologic surgeon, family doctor or other physician on these conditions.

Men

Men whose testes produce abnormally low amounts of testosterone (hypogonadism), may received testosterone replacement therapy. For some men, lower than normal testosterone produces no apparent effects; for others, effects of this condition may include:

  • reduced sexual function, in terms of desire, erections and fertility;
  • insomnia or other sleep problems;
  • reduced muscle size and strength, more body fat and lower bone density;
  • and emotional changes, such as less confidence and motivation, lower mood and difficulty in concentration and memory.
Testosterone therapy in women; estrogen in menMany people are surprised to learn that testosterone is present and serves a normal function in women and that estrogen is naturally present and has effects in men. Testosterone plays a role in sexual function in women (and in energy levels, as does estrogen). Estrogen also plays a less-well understood role in men.

Physicians have not reached consensus on the value of testosterone therapy for women-a complicated subject that requires additional study. The hormone is sometimes prescribed for reduced sexual function and desire in women, and other effects of menopause. But the woman must have adequate estrogen levels or also be undergoing estrogen replacement therapy. The therapy also has side effects.

The role of small amounts of estrogen naturally present in men is not fully understood but, just as in women, the hormone appears to play a role in cardiovascular health. Likewise, it may also have effects on mood or mental function. Whether estrogen therapy has a role, though, for men is yet to be determined. Too much estrogen is a known risk in men, including for osteoporosis, breast development, and other effects.

Gradual reduction of testosterone levels is a normal part of aging. Findings are not conclusive about whether testosterone therapy for men who are experiencing this normal aging effect are beneficial. What’s more, testosterone may have negative side effects, including increased risk of prostate enlargement and testicular shrinkage. Men seeking testosterone therapy for normal aging are urged to speak to their primary doctor or a Lourdes endocrinologist in weighing this decision.

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