Endocrine Abstracts

This talk will discuss a programme of clinical and translational work that has aimed to improve care for people with complex reproductive and hormonal disorders within the NHS. The focus has been on areas of high patient need but limited evidence. Key work has evaluated the safety, efficacy and cost-effectiveness of treatment for symptomatic men aged over 40 years with low testosterone. This has included research and expert consensus to refine biochemical testing and assay interpretation, allowing clinicians to use more accurate and clinically meaningful thresholds when diagnosing hypogonadism. The increasing trend for testosterone seeking behaviour in men imposes a new challenge for NHS clinicians; novel community-based research to delineate the characteristics of androgen withdrawal may help us support men who are motivated to stop self-medicating. Other recent work has revealed improvements in spermatogenic markers in men with obesity following dietary weight loss. Furthermore, development of novel seminal markers has revealed a male determinant of previously unexplained recurrent pregnancy loss. Developing NHS services, is a major theme of this work. The Society for Endocrinology Specialist Endocrinology Network for Andrology was established to bring individual centres of excellence together to harmonise service development, manage drug shortages, and undertake collaborative research. This work has also contributed directly to national and international guidelines, helping shape evidence-based standards for reproductive endocrine care. Education and workforce development underpin this programme. Training clinicians in the UK and worldwide to confidently manage complex reproductive endocrine conditions, and has build sustainable expertise within the NHS. Overall, a case is made for integrating clinically driven research, training, service design, and guideline development to advance the treatment of reproductive hormone disorders across the NHS.