Reproductive Endocrinology
Reproductive endocrinology focuses on diagnosing and treating conditions that affect fertility and menstrual health. From menstrual issues to conditions that impact conception, specialised care can help individuals achieve reproductive wellness.
At our clinic, we offer personalised, evidence-based treatments to address fertility concerns and irregular menstrual cycles. Learn more about reproductive endocrinology conditions and book an appointment with us today.
Types of Reproductive Endocrinology Conditions
Reproductive endocrinology conditions can affect males and females. These are some of the common conditions we treat.
Male infertility
Fertility in men gradually declines with age, typically starting between 40 and 45 years old, as sperm quality and reproductive function decrease. However, male infertility can also arise from various factors, including low sperm production, abnormal sperm function, or blockages that hinder sperm delivery.
In Singapore, around 15% of couples experience difficulty conceiving, with male infertility contributing to nearly half of these cases1. Seeking early medical evaluation can help identify underlying causes and improve the chances of conception.
Causes
There are many causes of male infertility including:
- Hormonal changes: Imbalances in hormones such as testosterone or prolactin can reduce sperm production, while blockages in the reproductive tract can prevent sperm from being present in semen.
- Urogenital conditions: Conditions such as varicoceles, retrograde ejaculation, and azoospermia can disrupt sperm production or transport, leading to infertility.
- Sexual dysfunction: Issues such as erectile dysfunction or premature ejaculation can make conception challenging and may be worsened by stress.
- Blockages in the reproductive system: A previous infection or vasectomy could cause a blockage in the vas deferens and prevent sperm from exiting.
- Environmental and lifestyle factors: Sperm health can be affected by heat, toxins, alcohol, smoking, poor diet, and lack of physical activity, so men trying to conceive should avoid these risks.
- Immunologic infertility: In rare cases, the immune system mistakenly attacks sperm, impairing their movement and function, which hinders fertilisation.
Symptoms
The primary sign of male infertility is the inability to conceive a child despite regular, unprotected sexual intercourse.
In some cases, male infertility may be linked to an underlying condition, such as a genetic disorder, hormonal imbalance, dilated veins around the testicles (varicocele), or a blockage affecting sperm transport. These conditions can cause noticeable signs and symptoms, including:
- Sexual function issues, such as difficulty with ejaculation, low semen volume, reduced libido, or erectile dysfunction
- Pain, swelling, or a lump in the testicular area
- Frequent respiratory infections
- Impaired sense of smell
- Enlarged breast tissue (gynecomastia)
- Reduced facial or body hair or other signs of hormonal or chromosomal abnormalities
- Low sperm count
Female infertility
Infertility is typically diagnosed in females who have been trying to conceive for one year without success if under 35 or six months if they are over 35. However, some individuals may receive a diagnosis earlier if they have known medical conditions, such as polycystic ovary syndrome (PCOS), endometriosis, or uterine factor infertility, which can affect conception.
The likelihood of infertility increases with age, as ovarian reserve and egg quality naturally decline over time.
Causes
Female infertility can result from various factors that affect ovulation, the reproductive organs, or overall fertility health. Some possible causes of female infertility include:
- Age-related decline: Fertility naturally decreases with age, particularly after the mid-30s, due to a reduction in egg quality and quantity.
- Ovulation disorders: Conditions such as PCOS can significantly affect the chances of pregnancy.
- Endometriosis: This condition occurs when tissue similar to the uterine lining grows outside the uterus, leading to inflammation, pelvic pain, and potential fertility challenges.
- Uterine and fallopian tube abnormalities: Scar tissue in the fallopian tubes from previous surgeries can block sperm from reaching the egg, while fibroids or uterine scarring may interfere with embryo implantation.
- Hormonal imbalances: Hyperprolactimona, hyper or hypothyroidism, Cushing’s disease, pituitary adenoma, premature ovarian failure etc.
Symptoms
The most common symptom of female infertility is the inability to conceive despite regular, unprotected sexual intercourse. Other symptoms of female infertility linked to existing ovulation disorders include absent or irregular periods.
Irregular periods
Irregular menstrual cycles, including missed or infrequent periods, can be a sign of underlying health conditions that affect fertility. Missing more than three periods either consecutively or over a year may indicate amenorrhea (absence of periods) or oligomenorrhea (infrequent periods).
Primary amenorrhea refers to when a girl does not get her first period after the age of 15. Secondary amenorrhea refers to when a woman who already menstruates does not get her period for 3 consecutive months or more. Lastly, oligomenorrhea refers to infrequent periods, where the menstrual cycle occurs less than 6 times per year.
Causes
The underlying causes of irregular periods depend on the type of menstrual cycle disorder.
| Symptom | Details |
|---|---|
Primary amenorrhea |
|
Secondary amenorrhea |
|
Oligomenorrhea |
|
Symptoms
While slight variations in cycle length are normal, certain changes may indicate irregular menstruation. Signs of an irregular period include:
- Unpredictable cycle length: This is when periods occur less than 21 days or more than 35 days apart.
- Missed periods: This is when three or more periods are skipped consecutively without pregnancy or menopause.
- Abnormal menstrual flow: Bleeding may be significantly heavier or lighter than usual.
- Prolonged bleeding: If periods last more than 7 days per cycle, bleeding is considered prolonged.
- Inconsistent cycle length: The length of time between cycles can fluctuate by more than 9 days.
- Severe symptoms: Menstruation is accompanied by intense pain, cramping, nausea, or vomiting.
- Unexpected bleeding: Spotting or bleeding occurs between periods, after menopause, or following sexual intercourse.
Diagnosing Reproductive Endocrinology Conditions
A thorough understanding of your medical history is essential for identifying potential risk factors related to infertility, irregular menstrual cycles, or hormonal imbalances. By assessing your menstrual cycle patterns, family history, and lifestyle factors such as stress, diet, and exercise, our endocrinologist can gain valuable insights into underlying reproductive health concerns.
A physical and pelvic examination also allows for the detection of visible signs associated with reproductive disorders, including PCOS and endometriosis. These assessments help identify symptoms such as abnormal hair growth or pelvic tenderness, guiding further diagnostic evaluations and treatment plans.
Hormone tests are essential in diagnosing ovulatory disorders, PCOS, and thyroid-related infertility. Key hormone assessments include:
- Follicle-stimulating hormone (FSH)
- Luteinising hormone (LH)
- Oestrogen
- Prolactin
For male fertility assessment, semen analysis measures sperm count, shape, and motility to determine if infertility is due to low sperm production or abnormal sperm function.
Pelvic ultrasounds and MRIs are crucial in detecting reproductive abnormalities, including:
- Ovarian cysts
- Fibroids
- Uterine structural abnormalities
To assess fallopian tube patency and uterine abnormalities, additional imaging tests include hysterosalpingography (HSG) and saline infusion sonohysterography (SIS).
HSG is an X-ray test using contrast dye to identify fallopian tube blockages and uterine shape abnormalities. On the other hand, SIS is an ultrasound-based test that provides a detailed view of the uterine cavity and detects conditions contributing to recurrent miscarriage or infertility.
There are two main types of minimally invasive procedures: laparoscopy and hysteroscopy. Laparoscopy is a keyhole surgical procedure that allows direct visualisation of the reproductive organs, aiding in the diagnosis of conditions such as endometriosis, pelvic adhesions, or blocked fallopian tubes.
Similarly, hysteroscopy is a minimally invasive technique used to examine the uterine cavity. This allows for the effective diagnosis and treatment of abnormalities like fibroids, polyps, or uterine septa, which may affect implantation and pregnancy outcomes.
Treating Reproductive Endocrinology Conditions
Treatment for reproductive endocrinology conditions varies depending on the underlying issue and your individual needs.
| Types of treatment | |
|---|---|
Male infertility |
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Female infertility |
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Irregular periods |
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Our Reproductive Endocrinologist
Dr Linsey Gani
Consultant Endocrinologist
MBBS (Aust), B Med Sci, FRACP (Endocrine), FAMS (S’pore), MPH (Harvard), Clinical Assistant Professor (Duke-NUS Medical School)
Languages: English, Mandarin, Bahasa Indonesia
Dr Gani is an experienced endocrinologist trained in diagnosing and treating reproductive health disorders. Her expertise spans conditions related to hormonal imbalances, including those affecting fertility, menstrual health, and reproductive function. Dr Gani completed her residency in Melbourne, Australia. She is a fellow of the Royal Australian College of physician and the Academy of Medicine, Singapore.
Why Choose Us?
We understand that dealing with reproductive and infertility issues can be stressful. At our clinic, we treat patients with empathy and care as they navigate this journey towards better reproductive health.
Dr Gani combines her medical expertise with evidence-based practices to provide accurate diagnoses and tailored treatment plans for reproductive and endocrine health.
LG Endocrinology offers a full range of reproductive and endocrine services tailored to your needs so you can benefit from a holistic treatment plan.
FAQs About Reproductive Endocrinology
What is the difference between a reproductive endocrinologist and an endocrinologist?
An endocrinologist is a specialist who diagnoses and treats a wide range of hormone-related conditions, including diabetes, thyroid disorders, adrenal gland disorders and osteoporosis. They focus on how hormones regulate metabolism, growth, and overall health.
A reproductive endocrinologist, on the other hand, specialises in fertility-related hormone disorders and reproductive health. They diagnose and treat conditions such as recurrent miscarriage and infertility.
As some reproductive conditions, such as irregular periods or infertility, can be linked to other underlying endocrinological conditions, seeing an endocrinologist can offer more holistic care. Book an appointment with us today to discuss your symptoms with our endocrinologist.
Should I see a reproductive endocrinologist or a fertility specialist?
We recommend seeing a reproductive endocrinologist or endocrinologist for your reproductive health.
A fertility specialist does not require specific training or certification in reproductive medicine. However, a board-certified reproductive endocrinologist has advanced training in reproductive medicine, hormonal disorders, and fertility treatments.
As such, choosing a board-certified reproductive endocrinologist ensures that you receive evidence-based care from a specialist with rigorous medical training.
Should I see a reproductive endocrinologist or a gynaecologist?
A gynaecologist focuses on general female reproductive health, managing menstruation, contraception, pregnancy, and menopause. They provide routine care, perform pap smears, and treat common gynaecological conditions such as fibroids and infections.
On the other hand, a reproductive endocrinologist is a specialist trained to diagnose and treat infertility and hormonal disorders affecting conception in both males and females.
If you are having difficulty conceiving, experiencing recurrent miscarriages, or struggling with hormonal imbalances like PCOS or endometriosis, a reproductive endocrinologist can provide fertility treatments tailored to your needs. Book an appointment with us today.
- Retrieved from Hope for infertility
Book an Appointment
Fill out the form below to schedule your appointment.
Dr. Linsey Gani Endocrinology
10 Sinaran Drive, #10-08, Novena Medical Center, Singapore 307506
+65 6397 7101
+65 9128 7480
Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00-12:00
Closed
Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00 - 12:00
Closed