REGULAR EXAMINATIONS WITH A GYNECOLOGIST IS as much a part of taking care of your health as brushing your teeth and physical activity. Recently, the amount of knowledge about our body has increased significantly, and it became clear that the best approach to understanding many processes is to combine several medical disciplines, such as gynecology and endocrinology. We asked Irina Vyatkina, candidate of medical sciences, endocrinologist at the Marina Ryabus Clinic , who is a gynecologist-endocrinologist and why everyone needs such a specialist.
The difference between a gynecologist-endocrinologist and an ordinary endocrinologist, for example, is that the former has no right to treat patients with diabetes mellitus, and the latter has no right to conduct a gynecological examination. To simplify completely, hormones are the main specialty for an endocrinologist, and an additional specialty for a gynecologist-endocrinologist. Most likely, he received a diploma as an obstetrician-gynecologist, and studied endocrinology additionally.
This specialization is a deep study of biochemical processes in the body. Hormones are not only responsible for reproductive function and libido – they regulate almost all key processes: mood, sleep, immunity, weight, fatigue, appetite and food addictions, exposure to stress and chronic diseases, intelligence, memory and even character.
It turns out that a gynecologist-endocrinologist is a specialist with a systematic approach who can be asked almost any question. He will understand the relationship of your symptoms, prescribe the necessary studies, and if the question turns out to be non-core for him, he will refer you to another specialist. All this does not mean that gynecologists without specialization in hormones are bad doctors. In any case, the gynecologist has an understanding of how the human body works – and if it is, for example, a surgeon, then he does not need to understand the microdoses of hormones.
A gynecologist-endocrinologist is a doctor who guides a woman from her first menstrual period to deep menopause. In fact, its goal is to help the patient gently enter the reproductive age, monitor her health in the fertile period, and then help smoothly leave the reproductive age. The doctor helps very young girls in case of skin inflammation, painful periods, sudden weight gains, and so on. At this stage, the doctor must make sure that the cycle has become regular, the hormonal background is even, and the body, after going through puberty, is working as it should.
For patients of reproductive age, the doctor selects suitable methods of contraception or helps with the planning of pregnancy and childbirth. At this age, women often need help with balancing hormonal levels: they can complain of PMS, skin inflammation and unstable weight, experiment with lifestyle and diets, and experience stress at work.
Some patients at the beginning of menopause want to maintain a youthful appearance and reproductive potential – and someone just wants to enter a new stage of life smoothly, without “hot flashes” and mood swings. At this time, metabolism slows down, weight is gained, hormonal signs of aging of the face and hair appear, someone notices “hot flashes”, fatigue, decreased libido – if desired, these conditions can be corrected if you start to deal with them on time. Perimenopausal hormone replacement therapy significantly reduces the risk of certain types of cancer and can add a decade or two of active longevity. Finally, the doctor helps patients in deep menopause with the prevention of osteoporosis .
But in general, the list of issues that the gynecologist-endocrinologist deals with is much wider. Unfortunately, most people do not think to talk to a doctor if they suddenly become drawn to sweets, an intolerance to smells has appeared, or an autumn blues attacked. But in reality, a huge number of problems that we used to attribute to age, laziness and weak will, hormonal and amenable to elementary correction. By the way, midlife crisis is also often a hormonal problem.
You should go to a gynecologist-endocrinologist if you have acne, your hair begins to fall out, wrinkles and creases appear sharply, within a few months, your complexion deteriorates; if you get tired quickly, feel depressed, you do not want to go anywhere and see anyone, your libido has decreased; if you gain weight, eating as before, you are drawn to certain foods, if you have an intolerance to smells; if everything enrages you, you notice in yourself or in your loved ones memory and concentration disorders, grumpiness, if you began to react differently to physical activity and you need more time in the gym to stay in the same shape. We have already written that such symptoms are a reason to consult a psychotherapist , but a good specialist will definitely ask you to be examined by an endocrinologist before starting treatment.
These and many other problems may be in the area of ​​responsibility of the gynecologist-endocrinologist. Solving them on your own, by moral and volitional efforts, is not worth it. For example, if you gain weight due to vitamin D imbalance, insulin resistance, contraceptive use, or diabetes, controlling your appetite will not only be difficult, but pointless.
Treatment by a gynecologist-endocrinologist does not at all imply that you will certainly be prescribed hormonal drugs. Despite popular belief, this specialist treats not only with hormones. Often, if a minor correction is required, it is enough to prescribe vitamins, trace elements, change the daily regimen or exclude some foods – all this also affects the metabolism of hormones. But even if you have been prescribed hormonal correction, you do not need to be afraid of it: modern drugs are safe and the active substance is contained in them in microscopic doses.
Nevertheless, you do not need to prescribe hormonal drugs or even simply “check hormones” yourself. The fact is that a standard set of endocrinological studies simply does not exist – the list of necessary tests is selected individually. Therefore, it will not work just to go and donate blood for abstract hormones. In addition, in addition to hormones, you need to check some vitamins and trace elements – and you can’t figure out their list without a doctor. It is also important that hormone levels can be determined on different days of the menstrual cycle, and on the eve of donating blood, you need to follow sometimes unobvious recommendations – before testing for prolactin, for example, you cannot have sex, and before some others, there are certain foods.
Research methods are also different: for some indicators, standard ones are suitable, for others only the most advanced ones, such as mass spectrometry. Not every laboratory has the equipment for such analysis, and a good clinic will simply send the appropriate blood samples to where they can be examined correctly.
Finally, if you donated blood yourself and saw that all indicators are within the normal range, this does not mean anything. “Normal range” is a very conventional concept, not all laboratories update it on time, and it does not take into account the individual parameters that the doctor will take into account. Therefore, in one patient, an indicator close to the upper limit of the norm will already be a deviation, while in another, exceeding the laboratory range, on the contrary, will be normal for her. In addition, the test results cannot be interpreted separately from each other. An increase in the level of microelement A against the background of a low concentration of hormone B may indicate one thing, against a background of a high one – about the exact opposite, and the same thing, but in a patient with Middle Eastern roots – generally about the third.
For all these reasons, it is better not to interpret the test results on your own: at best, you will throw out a serious amount and get nervous in vain, and at worst, you miss something important or disrupt the hormonal background with incorrect prescriptions. It is better to find a good gynecologist-endocrinologist – this is exactly the specialist who can become your main doctor for life.