Hypogonadism: Difference between revisions

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=== Clinic ===
=== Clinic ===


* Hypogonadism means diminished functional activity of the gonads, that may result in diminished production of sex hormones.  
* Diminished functional activity of the gonads, that may result in diminished production of sex hormones.
* Low androgen (e.g., testosterone) levels are referred to as hypoandrogenism and low estrogen (e.g., estradiol) as hypoestrogenism.
* Hypoandrogenism (Low androgen e.g., testosterone) and Hypoestrogenism (Low estrogen e.g., estradiol)


* Hypogonadism, commonly referred to by the symptom "low testosterone" or "Low T", can also decrease other hormones secreted by the gonads including progesterone, DHEA, anti-Müllerian hormone, activin, and inhibin.  
* Hypogonadism, commonly referred to "low testosterone" and can also decrease other hormones including progesterone, DHEA, anti-Müllerian hormone, activin, and inhibin.
* Spermatogenesis and Ovulation may be impaired which causes complete infertility.
* Spermatogenesis and Ovulation may be impaired which causes complete [[Infertility remedies|infertility]].
* Hypogonadism can involve just hormone production or just fertility, but most commonly involves both.
** Examples of hypogonadism that affect hormone production more than fertility are hypopituitarism and Kallmann syndrome; in both cases, fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement.
** Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndrome and Kartagener syndrome.


=== Classification ===
=== Types ===
 
*
*


==== Primary hypogonadism ====
==== Primary hypogonadism ====


* LH and/or FSH are usually elevated, since the problem is in the Testicles / Ovaries (Hyper-gonatropic hypogonadism)
*Genetic: Klinefelter syndrome, Turner syndrome, Noonan syndrome, XY with SRY gene-immunity
*Genetic: Klinefelter syndrome,Turner syndrome, Noonan syndrome, XY with SRY gene-immunity
* Acquired: [[MMP, Mumps|MMP]]   
* Acquired: [[MMP, Mumps|MMP]]   
LH and/or FSH are usually elevated, since the problem is in Testicles / Ovaries (Hyper-gonatropic hypogonadism)




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* Hypogonadotropic hypogonadism (HH) due to Hypopituitarism / Pituitary hypoplasia.
* Hypogonadotropic hypogonadism (HH) due to Hypopituitarism / Pituitary hypoplasia.
* Central hypogonadism referring to CNS / Hypothalamic defects: Kallmann syndrome
* Lack of hormone response is AIS (Androgen Insensitivity Syndrome)
* Lack of hormone response is AIS (Androgen Insensitivity Syndrome)
* Isolated hypogonadotropic hypogonadism (IHH)= Idiopathic or congenital hypogonadotropic hypogonadism (CHH): HH due to deficiency in or insensitivity to GnRH where the function and anatomy of the anterior pituitary is normal and secondary causes of HH are not present
* Isolated hypogonadotropic hypogonadism (IHH)= Idiopathic or congenital hypogonadotropic hypogonadism (CHH): HH due to deficiency in or insensitivity to GnRH where the function and anatomy of the anterior pituitary is normal and secondary causes of HH are not present
*In secondary hypogonadism, LH / FSH are normal or low, suggesting the problem is in the brain (Hypo-gonatropic hypogonadism
*In secondary hypogonadism, LH / FSH are normal or low, suggesting the problem is in the brain (Hypo-gonatropic hypogonadism
*E.g. PCOS, and Kallmann syndrome. Hemochromatosis and Diabetes mellitus can be the etiology.
*Examples are
**[[PCOD, PCOS, Poly Cystic Ovarian Disease (Syndrome) remedies|PCOS]]
**Kallmann syndrome
**Hemochromatosis  
**Diabetes mellitus






=== Central Hypogonadism ===
=== Central Hypogonadism ===
It may be due to:


* Genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development)
* Central hypogonadism referring to CNS / Hypothalamic defects including:
* Infections, including HIV
** Genetic disorders such as Kallmann syndrome (Abnormal hypothalamic development)
* Pituitary disorders
** Infections including HIV
* inflammatory diseases, including sarcoidosis, MTB, and histiocytosis
** Pituitary disorders
** Inflammatory diseases including sarcoidosis, [[MTB, Mycobacterium tuberculosis|MTB]] and histiocytosis


**


=== Hormones vs. fertility ===
Hypogonadism can involve just hormone production or just fertility, but most commonly involves both.


* Examples of hypogonadism that affect hormone production more than fertility are hypopituitarism and Kallmann syndrome; in both cases, fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement.
=== Other ===
* Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndrome and Kartagener syndrome.
Hypogonadism can occur in other conditions, like Prader–Willi syndrome.


=== Other[edit] ===
Hypogonadism can occur in other conditions, like Prader–Willi syndrome.<sup>[''citation needed'']</sup>




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=== Hypogonadotrophic hypogonadism ===
=== Hypogonadotrophic hypogonadism ===


* It is a subtype of hypogonadism,
* It is a subtype of hypogonadism
* Late, incomplete or lack of development at puberty
* Late, incomplete or lack of development at puberty
* Sometimes short stature or the inability to smell
* Sometimes short stature or the inability to smell
* In females, a lack of breasts and menstrual periods, and in males a lack of sexual development, e.g., facial hair, penis and testes enlargement, deepening voice.
* In females, a lack of breasts and menstrual periods, and in males a lack of sexual development, e.g., facial hair, penis and testes enlargement, deepening voice.

Revision as of 02:21, 6 April 2023

Clinic

  • Diminished functional activity of the gonads, that may result in diminished production of sex hormones.
  • Hypoandrogenism (Low androgen e.g., testosterone) and Hypoestrogenism (Low estrogen e.g., estradiol)
  • Hypogonadism, commonly referred to "low testosterone" and can also decrease other hormones including progesterone, DHEA, anti-Müllerian hormone, activin, and inhibin.
  • Spermatogenesis and Ovulation may be impaired which causes complete infertility.
  • Hypogonadism can involve just hormone production or just fertility, but most commonly involves both.
    • Examples of hypogonadism that affect hormone production more than fertility are hypopituitarism and Kallmann syndrome; in both cases, fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement.
    • Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndrome and Kartagener syndrome.

Types

Primary hypogonadism

  • Genetic: Klinefelter syndrome, Turner syndrome, Noonan syndrome, XY with SRY gene-immunity
  • Acquired: MMP

LH and/or FSH are usually elevated, since the problem is in Testicles / Ovaries (Hyper-gonatropic hypogonadism)


Secondary hypogonadism

  • Hypogonadotropic hypogonadism (HH) due to Hypopituitarism / Pituitary hypoplasia.
  • Lack of hormone response is AIS (Androgen Insensitivity Syndrome)
  • Isolated hypogonadotropic hypogonadism (IHH)= Idiopathic or congenital hypogonadotropic hypogonadism (CHH): HH due to deficiency in or insensitivity to GnRH where the function and anatomy of the anterior pituitary is normal and secondary causes of HH are not present
  • In secondary hypogonadism, LH / FSH are normal or low, suggesting the problem is in the brain (Hypo-gonatropic hypogonadism
  • Examples are
    • PCOS
    • Kallmann syndrome
    • Hemochromatosis
    • Diabetes mellitus


Central Hypogonadism

  • Central hypogonadism referring to CNS / Hypothalamic defects including:
    • Genetic disorders such as Kallmann syndrome (Abnormal hypothalamic development)
    • Infections including HIV
    • Pituitary disorders
    • Inflammatory diseases including sarcoidosis, MTB and histiocytosis


Other

Hypogonadism can occur in other conditions, like Prader–Willi syndrome.


Signs / Symptoms

  • Women: Amenorrhea, Decreased height+ Impaired Breast development Or Cessation of menstruation + Lowered libido + Loss of body hair + Hot flashes.
  • Men: Impaired muscle + Impaired body hair development + Gynecomastia + Decreased height + Erectile dysfunction + Sexual difficulties.
  • Central hypogonadism: Headaches + Impaired vision / Double vision + Milky discharge from the breast (Prolactin) + Symptoms caused by other hormone problems.


Hypogonadotrophic hypogonadism

  • It is a subtype of hypogonadism
  • Late, incomplete or lack of development at puberty
  • Sometimes short stature or the inability to smell
  • In females, a lack of breasts and menstrual periods, and in males a lack of sexual development, e.g., facial hair, penis and testes enlargement, deepening voice.
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