Gynaecological endocrinology · Marrakech
Periods that go awry, acne that persists, hair that appears, a pregnancy that is slow: behind these signs, hormones are often involved, but not always where we look. In Marrakech, Dr Oussama Rachid, an obstetrician-gynaecologist trained in reproductive medicine, sees you to understand what is happening, choose the useful tests and propose suitable treatment. This page is informational and does not replace a consultation.
Polycystic ovary syndromePolycystic ovary syndrome is a common hormonal disorder that affects about one woman in ten of childbearing age. It shows mainly as irregular or absent periods, sometimes marked acne or hair growth, and can delay pregnancy. It is diagnosed by examination, ultrasound and a blood test, and managed in a personalised way: lifestyle, regulating the cycle, treating the signs, help with ovulation if a pregnancy is wanted.View the page 
EndometriosisEndometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause very painful periods, pelvic pain or pain during intercourse and difficulty conceiving, but some women have no symptoms. It is diagnosed by examination and imaging and treated in a personalised way, with medicines or sometimes surgery.View the page 
AdenomyosisAdenomyosis is a benign condition in which tissue similar to the lining of the uterus settles in the muscular wall of the uterus. It mainly causes heavy and painful periods, sometimes an enlarged uterus. It is diagnosed by ultrasound and MRI and treated according to age and plans for pregnancy.View the page The cycle is driven by a dialogue between the brain (hypothalamus and pituitary) and the ovaries. The brain hormones, FSH and LH, stimulate the ovaries; the ovaries make oestrogen, which prepares ovulation, then progesterone, which prepares the uterus for pregnancy. Other glands play a part: the thyroid, the adrenals and the hormone prolactin.
A grain of sand at any level can disturb the whole: this is what we explore.
A gynaecological endocrinology consultation is useful in case of:
PCOS is one of the most common hormonal disorders in women of childbearing age. It combines, to varying degrees, irregular cycles linked to infrequent ovulation, an excess of male hormones (acne, hair growth) and ovaries with a polycystic look on ultrasound. It is often linked to insulin resistance.
Management depends on your priorities: regularising cycles, treating acne or hair, conceiving, or preventing metabolic complications. Lifestyle measures (physical activity, balanced diet, weight) often have a major effect.
Absence of periods (amenorrhoea) has many causes: pregnancy, stress, significant weight loss or gain, intense exercise, PCOS, thyroid disorder, excess prolactin, ovarian insufficiency, uterine anomaly. The doctor looks for them logically, starting with a pregnancy test.
A cause is almost always found, and solutions exist: do not wait months hoping it will sort itself out.
These signs can reflect an excess of male hormones (androgens), produced by the ovaries or adrenals, or a particular sensitivity of the skin. Examination and chosen tests help find the cause. Depending on the case, a hormonal or anti-androgen treatment may be offered, alongside skin care and dermatological management.
These treatments do not suit everyone and require monitoring: they are decided at consultation.
Excess prolactin can block ovulation and cause nipple discharge: it is most often due to a small benign pituitary adenoma or certain medicines, and is well treated. A thyroid disorder (underactive or overactive) can disturb the cycle and fertility and is corrected by suitable treatment.
Both causes are looked for routinely when the cycle is disturbed or pregnancy is slow.
When periods stop before 40, it is called premature ovarian insufficiency. It requires tests, support and reflection on fertility and protection of bones and heart.
An AMH test, which reflects the stock of eggs (ovarian reserve), is sometimes offered: it informs about the reserve, but does not on its own predict the chances of pregnancy. It is interpreted with age and context.
A hormone test is chosen according to your history, never "to cover everything". Depending on the question asked, it may include FSH, LH, oestradiol, prolactin, TSH, AMH, testosterone and other tests. For some tests the time in the cycle matters (often between the second and fifth day of the period); others can be done at any time.
Tell the doctor if you take a pill or a hormone treatment: they change some results. The doctor explains each result and what it changes.
Treatment depends on the cause and your plans: hormonal contraception for therapeutic purposes to regulate a cycle or acne, thyroid treatment, treatment of excess prolactin, gentle ovulation stimulation when planning a pregnancy, management of weight and insulin, hormone treatment of perimenopause or menopause.
The doctor presents the benefits, limits and side effects of each option before deciding with you.
No "hormone rebalancing programme" with supplements or miracle diets, no multiple tests without a precise question, no hormone treatment without an indication. Only examinations and treatments useful for your situation are offered.
The procedures and examinations linked to this care. Each is offered after a consultation, according to your situation.
Hormone tests
Understanding a cycle or ovulation disorder through chosen tests.
Not always at once. The doctor begins with the history, examination and sometimes an ultrasound, then chooses the useful tests.
It regularises periods and can improve acne and hair growth, but it does not cure PCOS. Other measures, such as physical activity and a balanced diet, are important.
It depends on the tests: often between the second and fifth day of the period for some, any time for others. The doctor tells you.
It reflects the egg reserve, not egg quality or, on its own, your chances of pregnancy.
Yes, significant stress can disturb the cycle temporarily. But absent or very irregular periods should not be put down to it without examination.
Yes, many women do, sometimes with simple help to trigger ovulation.
Informational content: it does not replace a consultation. No outcome can be guaranteed.
