{"id":4368,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/reproductiveendocrinology\/"},"modified":"2023-08-30T09:56:57","modified_gmt":"2023-08-30T08:56:57","slug":"reproductiveendocrinology","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/endocrinology\/reproductiveendocrinology\/","title":{"rendered":"Reproductive Endocrinology"},"content":{"rendered":"\nReproductive Endocrinology<\/title>\n\n\n\n<p><strong>Information <\/strong><\/p>\n\n\n\n<p>There is some overlap between the services provided by general endocrinology and those provided by the Department of Reproductive Endocrinology which is situated within Edinburgh Fertility Centre. The referral guide provides advice on which patients should be referred to Reproductive Endocrinology. <br><\/p>\n\n\n\n<p>Any patients seeking help with conception should be referred as a couple to the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/fertilityreproductive-endocrinology\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/fertilityreproductive-endocrinology\/\" target=\"_blank\" rel=\"noreferrer noopener\">Fertility Service<\/a>  and not Reproductive Endocrinology. <br><\/p>\n\n\n\n<p>Please see Sexual and Reproductive Health for <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" target=\"_blank\" rel=\"noreferrer noopener\">guidance on the menopause<\/a> and for advice on <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/fsh-testing-for-menopausecontraception\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/fsh-testing-for-menopausecontraception\/\" target=\"_blank\" rel=\"noreferrer noopener\">use of FSH in assessing contraceptive needs<\/a><br><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">Women<\/h4>\n\n\n\n<p><strong>Women with signs of hyperandrogenism<\/strong><\/p>\n\n\n\n<p>Signs suggestive of hyperandrogenism include hirsutism, acne, male pattern baldness and deepening of the voice.<\/p>\n\n\n\n<p>Please also see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" target=\"_blank\" rel=\"noreferrer noopener\">investigation of suspected Polycystic Ovary Syndrome (PCOS).<\/a><\/p>\n\n\n\n<p><strong>Women with amenorrhoea\/oligomenorrhoea<\/strong><\/p>\n\n\n\n<p>Women aged <45 years with amenorrhoea or oligomenorrhoea particularly if any of the following are present:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Elevated prolactin<\/li>\n\n\n\n<li>Hirsutism<\/li>\n\n\n\n<li>Either elevated or low gonadotrophins (LH\/FSH)<\/li>\n<\/ul>\n\n\n\n<p>Initial investigation should include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>LH<\/li>\n\n\n\n<li>FSH<\/li>\n\n\n\n<li>Estradiol<\/li>\n\n\n\n<li>Testosterone \/ free androgen index (FAI)<\/li>\n\n\n\n<li>Prolactin<\/li>\n\n\n\n<li>TSH and T4<\/li>\n<\/ul>\n\n\n\n<p>Please see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" target=\"_blank\" rel=\"noreferrer noopener\">investigation of possible PCOS<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Men<\/h4>\n\n\n\n<p><strong>Men with a low morning testosterone wishing to conceive<\/strong><\/p>\n\n\n\n<p>Please refer to the guidance on low testosterone and investigation of suspected hypogonadism. Most such men should be referred to the General Endocrinology Service, but If fertility is or likely to become an issue, referral to Reproductive Endocrinology may be more appropriate.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Suggested investigation include:\n<ul class=\"wp-block-list\">\n<li>LH<\/li>\n\n\n\n<li>FSH<\/li>\n\n\n\n<li>Testosterone<\/li>\n\n\n\n<li>Prolactin<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p><strong>Women<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Those aged less than 18 years with pubertal delay or amenorrhoea – please refer to paediatric endocrinology.<\/li>\n\n\n\n<li>Women with regular periods and abnormal vaginal bleeding – please refer to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/abnormaluterinebleeding\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/abnormaluterinebleeding\/\" target=\"_blank\" rel=\"noreferrer noopener\">Gynaecology<\/a><\/li>\n\n\n\n<li>Women with difficult menopausal symptoms – please refer to the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" target=\"_blank\" rel=\"noreferrer noopener\">Menopause Clinic<\/a> at the Chalmers Centre.<\/li>\n\n\n\n<li>Women with a known diagnosis of Turner’s syndrome requiring annual follow-up should be referred to the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/menopause\/\" target=\"_blank\" rel=\"noreferrer noopener\">Menopause Clinic <\/a>at the Chalmers Centre.<\/li>\n\n\n\n<li>Women with hirsutism seeking laser therapy with no endocrine cause can be referred to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/lasertreatments\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/lasertreatments\/\" target=\"_blank\" rel=\"noreferrer noopener\">Dermatology<\/a> for treatment. <\/li>\n<\/ul>\n\n\n\n<p><strong>Men<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Men with erectile dysfunction and normal early morning testosterone. Please see resources and links for the <a rel=\"noreferrer noopener\" href=\"\/files\/sites\/2\/endo-rep-Updated-Investigation-of-suspected-male-hypogonadism.pdf\" target=\"_blank\">guidance on investigation of suspected hypogonadism and appropriate screening investigations<\/a>. Consider referral to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/erectiledysfunctionurol\/\">Erectile Dysfunction \u2013 RefHelp (nhslothian.scot)<\/a>or to <a rel=\"noreferrer noopener\" href=\"\/refhelp\/SexualReproHealth\/ErectileDysfunction\" target=\"_blank\">Chalmers<\/a> when erectile dysfunction requires other approaches.<\/li>\n\n\n\n<li>Men not seeking to conceive with low early morning testosterone \u2013 if indicated, consider referral to <a href=\"\/refhelp\/Endocrinology\" target=\"_blank\" rel=\"noreferrer noopener\">General Endocrinology.<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>If referring women with suspected PCOS, please see the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/polycysticovarysyndrome\/\" target=\"_blank\" rel=\"noreferrer noopener\">RefHelp PCOS guidance on appropriate investigations<\/a>.<\/p>\n\n\n\n<p>If referring men with low testosterone, please see resources and links for guidance on <a href=\"\/files\/sites\/2\/endo-rep-Updated-Investigation-of-suspected-male-hypogonadism.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">investigation of suspected hypogonadism<\/a> and appropriate screening investigations<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Reproductive Endocrinology Information There is some overlap between the services provided by general endocrinology and those provided by the Department of Reproductive Endocrinology which is situated within Edinburgh Fertility Centre. The referral guide provides advice on which patients should be referred to Reproductive Endocrinology. Any patients seeking help with conception should be referred as a<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3908,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[131],"class_list":["post-4368","page","type-page","status-publish","hentry","category-reproductiveendocrinology"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/endocrinology\/reproductiveendocrinology\/\" rel=\"tag\">Reproductive Endocrinology<\/a>","rttpg_excerpt":"Reproductive Endocrinology Information There is some overlap between the services provided by general endocrinology and those provided by the Department of Reproductive Endocrinology which is situated within Edinburgh Fertility Centre. The referral guide provides advice on which patients should be referred to Reproductive Endocrinology. Any patients seeking help with conception should be referred as a","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4368","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4368"}],"version-history":[{"count":9,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4368\/revisions"}],"predecessor-version":[{"id":14502,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4368\/revisions\/14502"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3908"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}