What is endocrine gynaecology?
Endocrine gynaecology is the discipline concerned with the interactions between the hormonal system and gynaecological health. It explores hormonal dysfunctions that affect women at every stage of their lives: puberty, reproductive years, perimenopause, and menopause.
Hormones play a central role in regulating the menstrual cycle, ovulation, and fertility, as well as mood, weight, skin condition, and bone density. Even a subtle imbalance can affect overall female wellbeing.
Signs of a hormonal imbalance
The manifestations of a hormonal disorder are varied and sometimes misleading. Consult a specialist gynaecologist if you experience:
- Irregular menstrual cycles: absent (amenorrhoea), infrequent (oligomenorrhoea), or too frequent
- Heavy or painful periods persisting despite treatment
- Hormonal acne resistant to topical treatments, particularly along the jawline and neck
- Hirsutism: excessive hair growth on the face, chest, or abdomen
- Hair loss of androgenic origin (male-pattern alopecia)
- Unexplained weight gain or loss
- Chronic fatigue, sleep disturbances, irritability
- Difficulties conceiving
These symptoms may suggest several gynaecoendocrine conditions, which only a full hormonal panel will allow to be differentiated.
Conditions managed
Polycystic Metabolic Ovarian Syndrome (PMOS)
PMOS is the most common hormonal disorder in women of reproductive age (affecting around 10% of them). It combines irregular cycles, androgen excess (testosterone), and a polycystic appearance of the ovaries on ultrasound. It is the leading cause of infertility due to anovulation.
Management is individualised according to the patient's objective: cycle regulation, treatment of hirsutism, or fertility optimisation.
Hyperprolactinaemia
An elevated prolactin level can cause cycle disturbances, amenorrhoea, breast discharge (galactorrhoea), and infertility. The causes are multiple: pituitary adenoma, certain medications, hypothyroidism.
Thyroid disorders
The thyroid gland directly influences the menstrual cycle and fertility. Hypothyroidism (underactive thyroid) or hyperthyroidism can lead to irregular periods, weight gain, fatigue, or palpitations. A thyroid panel (TSH, free T4) is routinely included in the gynaecological hormonal assessment.
Hyperandrogenism
Excess androgens (male hormones) in women may be of ovarian origin (PMOS), adrenal origin (enzymatic block, tumour), or idiopathic. It presents as acne, hirsutism, and alopecia.
Perimenopause and premature menopause
The menopausal transition sometimes begins as early as age 40 with irregular cycles, hot flushes, sleep disturbances, and changes in libido. Menopause before the age of 40 (premature ovarian insufficiency) requires urgent specialist management.
The gynaecological hormonal panel
The panel is requested in the first half of the cycle (day 2 to 5), unless otherwise indicated. It typically includes:
- FSH, LH, oestradiol — assessment of ovarian reserve and the hypothalamic–pituitary axis
- AMH (anti-Müllerian hormone) — marker of ovarian reserve
- Total and free testosterone, DHEAS, delta-4-androstenedione — androgenic panel
- Prolactin
- TSH, free T4 — thyroid panel
- 17-OHP (17-hydroxyprogesterone) — screening for an adrenal enzymatic block
- Fasting blood glucose, fasting insulin, lipid profile — when insulin resistance is suspected
A pelvic ultrasound scan (preferably endovaginal) completes the morphological assessment.
Treatment options
Management is always personalised and takes into account the patient's profile, symptoms, and life plans.
Combined oral contraceptives — they regulate the cycle, reduce androgen excess, and improve acne and hirsutism.
Progestins — in cases of contraindication to oestrogens, they regulate the endometrium and the cycle.
Treatment of insulin resistance — metformin improves insulin sensitivity in PMOS and sometimes restores ovulation.
Specific treatments — dopaminergics for hyperprolactinaemia, thyroid hormone therapy for thyroid disorders, corticosteroids for adrenal blocks.
Ovulation induction agents — in cases of anovulation with a desire for pregnancy.
Why consult Dr. Maazouzi?
Dr. Yasmine Maazouzi practises endocrine gynaecology at the Hôpital Privé Beauregard in Marseille. She provides comprehensive follow-up: from the initial hormonal assessment to coordination with specialist endocrinologists and biologists, including regular adaptation of treatment.
Her approach combines diagnostic rigour with attentive listening: hormonal symptoms profoundly affect quality of life, and every patient deserves a precise and caring response.
An untreated hormonal imbalance can progress to complications (endometriosis, infertility, metabolic syndrome). The earlier the diagnosis, the more effective the management.
Consultations at the Hôpital Privé Beauregard — Building B5, ICOGM — Marseille 13004. Appointments via Doctolib.