Endocrine investigations at Bristol Hospital

Hormones help to regulate your body’s growth and function via your bloodstream. The major glands included in your endocrine system are:

• Hypothalamus
• Pituitary
• Thyroid
• Parathyroid
• Adrenals
• Pineal body
• Pancreas
• Reproductive organs (ovaries and testes)

If your hormone levels become unbalanced your endocrine system signals one or more of these glands to correct the level. The inability to restore the hormone balance is called an endocrine disorder.

Our endocrine investigations will help your consultant diagnose and treat endocrine disorders.

Amenorrhoea Screen (Female Hormone Screen)

Amenorrhoea is the absence of menstruation. Before puberty, during pregnancy and breast feeding or during and after the menopause, amenorrhoea is normal and described as Physiological Amenorrhoea. Primary Amenorrhoea is the initial failure of menstruation. It is regarded as abnormal if a girl has not started secondary sexual development and menstruation by the age of 14, or if a girl with normal secondary sexual characteristics has not started menstruation by the age of 16.

Secondary Amenorrhoea is the absence of menstruation for six consecutive months in a woman who previously had regular periods (excluding Physiological Amenorrhoea).

Impotence Profile (Erectile Dysfunction)

Impotence is the inability to achieve or maintain an erection. It is often a problem that is not openly discussed, but it affects many thousands of couples each year. The causes of impotence can be wide-ranging including physical or psychological problems. Impotence may be temporary and as a result of fatigue, stress or psychological factors or long term as a result of feelings of anxiety or guilt that may originate from childhood. It may also be a symptom of severe depression. Physical disorders (i.e. diabetes mellitus), damage to the spinal cord, hormone disorders and alcohol may also be a cause. Other causes include drugs for depression and high blood pressure and diuretic therapy.

Excess Hair (Hirsutism) Profile

Excess hair (hirsutism) is a common disorder affecting up to 8% of women. It often results from conditions that are not life-threatening such as when ovulation ends.

Androgens are the hormones that define male traits and reproductive system. Men and women produce androgens at different levels.  Women whose bodies produce too many androgens may experience hirsutism.

Infertility Profiles

There are degrees of infertility. The majority of infertile couples are actually sub-fertile meaning they are producing eggs and sperm but have difficulty conceiving due to disorders such as hormone imbalances and problems of the reproductive tract. Total infertility (where no eggs or sperm are produced) is rare.

Infertility can be due to a number of causes including hormone balance, infection, lifestyle and genetic factors. Our Infertility Profile establishes whether there is a hormonal cause for your infertility with a blood sample taken on Day 3 of the menstrual cycle. Other tests will check for rubella (measles) and screen your thyroid function.

Additional tests can be carried out such as Progesterone at day 21 of the cycle.

Women are born with their lifetime supply of eggs. The profile will assess your ovarian reserve - the number of eggs remaining in your ovaries. Ovarian reserve can be assessed by measuring levels of follicle stimulating hormone (FSH), Inhibin B and anti-mullerian hormone (AMH). These hormones all play a central role in ovulation. 

As menopause approaches, a woman’s FSH levels rise, while levels of Inhibin B and AMH fall.  AMH is a hormone produced by cells lining the small follicles within your ovaries. A follicle is a sac within the ovary which contains your developing eggs. 

In young women many eggs start to grow each day and quite large numbers reach the final stages of development. These women have high levels of AMH. In older women there are fewer eggs left in the ovaries. Few eggs will reach the final stages of development and the AMH level will be lower. 

Inhibin B is a hormone produced from small antral follicles. It suppresses FSH release. Inhibin B levels decrease during the early phase of development and prior to the increase in FSH levels. As the number of follicles decrease (expected as women age) there is usually a decrease in Inhibin B levels.

Menopause Screen

Menopause is the time in a woman’s life when the ovaries produce less oestrogen hormones, causing menstruation to stop. Menopause occurs most commonly between 45 and 55 years of age but can occur later or much earlier.

Symptoms of the menopause vary and may include:

• Tiredness
• Hot flushes
• Night sweats and sleeplessness
• Vaginal dryness
• Urinary tract infection
• Headache and joint pain
• Depression
• Reduced sex drive.

Some women have few menopausal symptoms and others require treatment such as Hormone Replacement Therapy (HRT).

Our Menopause Screen will help your consultant determine if you might benefit from further treatment.