Hypogonadism
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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.