Reproductive Endocrinology and Infertility

With an understanding of the biologic basis of the normal menstrual cycle, the diagnosis and management of abnormalities during the reproductive years can be addressed. Dysmenorrhea, endometriosis, premenstrual syndrome, abnormal uterine bleeding, and sexual dysfunction are common clinical syndromes that must be approached systematically. Amenorrhea can be due to anatomic factors (disorders of sexual differentiation, intrauterine adhesions, gestational trophoblastic disease), chronic anovulation (CNS-hypothalamic-pituitary dysfunction, inappropriate steroid feedback as in polycystic ovary syndrome, thyroid or adrenal disorders), or ovarian “failure” (menopause, genetic abnormalities, physical and environmental factors, autoimmune disease). Multiple male factors and female factors can cause infertility.