Hormonal questions need a specialized answer.

What it is about

According to the World Health Organization, about one in six people of reproductive age are affected by infertility. Once other causes have been ruled out, a hormonal disorder may be the main cause.

Hormonal disorders can affect every stage of reproduction. Even so, a specialized hormonal assessment is often missing from the work-up.

When to get checked

If there is no pregnancy after twelve months of regular sex. From 35, after six months.

Aim of the practice

What it is about

Polycystic ovary syndrome is the most common hormonal disorder in women of childbearing age. It affects 7-20% of women of reproductive age, depending on the diagnostic criteria used and the geographic region.

PCOS is a complex disorder. A genetic tendency is shaped by environmental influences already before birth. Because of these different influences, there are two types, four phenotypes and many forms. According to current knowledge, each form can have a different outlook. PCOS is a dynamic condition that changes over the course of each woman's life.

When to get checked

With cycle problems, extra hair growth, hair loss, acne, weight gain, mental health problems, or difficulty conceiving. The syndrome can also be present with regular periods. An early diagnosis is important.

Aim of the practice

What it is about

Endometriosis is a chronic, progressive disease in which cells of the womb lining grow outside the womb and cause anatomical, hormonal and inflammatory changes that affect quality of life. It affects about 10% of women, and current knowledge shows that it can stay with a woman for her whole life, even after menopause.

Besides pain and fertility problems, it is linked to a higher risk of heart and blood vessel disease, autoimmune and rheumatic diseases and certain cancers. Today endometriosis is seen as a disease of the whole body. Its treatment should therefore go beyond gynecology.

When to get checked

With period pain that limits daily life or hardly responds to painkillers, with pain during sex and when pregnancy does not happen. From the first symptoms to diagnosis, it takes 5 to 12 years on average. Early diagnosis is important, because endometriosis can progress and cause permanent changes to the organs.

Aim of the practice

What it is about

Perimenopause is the transition before menopause, when the reproductive phase of life comes to an end. Perimenopause can start quite early, from the age of 38 to 40, long before changes in a woman's periods become visible. Menopause itself happens on average at about 51.

Perimenopause and menopause are not hormonal disorders. They are normal phases in a woman's life. Even so, the hormonal changes often cause symptoms that disturb quality of life. Treatment is therefore often needed. Because women live longer today, they spend an ever larger part of their lives in this phase.

When to get checked

With hot flashes and night sweats, exhaustion, sleep problems, weight gain, mood swings, anxiety or low mood, problems concentrating, changes in skin and hair, less interest in sex, stronger PMS symptoms, joint pain, vaginal dryness or big changes in bleeding. Also if periods stop before the age of 40.

Aim of the practice

What it is about

A regular period is an important vital sign. When it stops, this is called amenorrhea: primary if a young girl never gets her first period, secondary if periods had started and then stop for more than three months. If the cycle is regularly longer than 35 days, this is called oligomenorrhea.

Amenorrhea can be a sign of a serious illness. Common causes are the thyroid, high prolactin, PCOS, large changes in weight, competitive sport or stress.

When to get checked

If the period stops for more than three months, the cycle is much shorter or longer, there is bleeding between periods, or the days before the period come with strong physical or emotional symptoms (PMS, PMDD). Also if the period becomes irregular or stops with intense training.

Aim of the practice

What it is about

Every girl goes through puberty at her own pace. Sometimes, though, it starts much too early or too late, or the first cycles are so difficult that school and daily life suffer.

When to get checked

If breast development starts before the age of 8, has not started by 13, or if there is still no period by 15. Also with very heavy or painful bleeding, or bleeding that is still very irregular, years after the menarche (the first period).

Aim of the practice

What it is about

Today there are many hormonal methods of contraception. Some contain estrogen and progestin, such as the combined pill, the vaginal ring and the patch. Others contain only progestin, such as the mini-pill, the hormonal IUD, the implant and the three-month injection. They differ in safety, use and side effects.

The choice should suit each individual woman. Age, smoking, weight, blood pressure, migraine, thrombosis in the woman herself or in the family and other illnesses all play a role.

When to get advice

Before first using contraception, with side effects such as spotting, mood changes or headaches, when changing method, after a pregnancy and from the age of 35.

Aim of the practice