Hypogonadism
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Hypogonadism
Classification & external resources</caption> <tbody><tr> <th>
ICD-
10</th> <td>
E28..3,
E29..1,
E23..0</td> </tr> <tr> <th>
ICD-
9</th> <td>
257.2</td> </tr> </tbody></table>
Hypogonadism is a medical term for a defect of the
reproductive system which results in lack of function of the
gonads (
ovaries or
testes). The gonads have two functions: to produce
hormones (
testosterone,
estradiol,
antimullerian hormone,
progesterone,
inhibin B),
activin and to produce
gametes (
eggs or
sperm). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature
menopause) in adults. Defective egg or sperm development results in
infertility.
The term hypogonadism is usually applied to permanent rather than transient or reversible defects, and usually implies deficiency of reproductive hormones, with or without
fertility defects. The term is less commonly used for infertility without hormone deficiency.
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[edit] Classification
There are many possible types of hypogonadism and several ways to categorize them.
[edit] by Congenital vs. acquired
[edit] by 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.
- Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndrome and Kartagener syndrome.
[edit] by Affected system
Hypogonadism is also categorized by endocrinologists by the level of the reproductive system which is defective.
[edit] Steroid use
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Hypogonadism may be induced by chronic use of
anabolic/androgenic steroids (AAS). The negative-feedback system of the
hypothalamic-pituitary-gonadal axis (HPTA) shuts down pituitary production of gonadotropins after extended exposure to AAS. This has been documented both in patients receiving AAS for legitimate medical reasons such as
AIDS or
cancer as well as athletes using AAS illicitly.
Hypogonadism may persist for some time after steroid use is discontinued.
[edit] Symptoms
Low Testosterone (Low T) symptoms include loss of energy, fatigue, loss of libido, muscle mass decline, decreased positive mood factors and an increased negative mood factors.
[edit] Diagnosis
Low Testosterone can be identified through a simple blood test performed by a physician. Normal testosterone levels range from 298 - 1098 ng/dl. Physicians measure
gonadotropins (
LH and
FSH) to distinguish primary from secondary hypogonadism. In primary hypogonadism the LH and/or FSH are usually elevated, while in secondary hypogonadism both are normal or low.
Hypogonadism is often discovered during evaluation of
delayed puberty, but ordinary delay which eventually results in normal
pubertal development and reproductive function is termed
constitutional delay.
[edit] Treatment
Hypogonadism is most often treated by replacement of the appropriate hormones. For men this is
testosterone. Commonly used testosterone formulations include transdermal testosterone, injectable testosterone, and buccal testosterone. Oral testosterone is no longer used in the U.S. because it is broken down in the liver and rendered inactive.
For women
estradiol and
progesterone are replaced. Some types of fertility defects can be treated; some cannot.
[edit] References
[edit] External links
ope::aktion033:discuss:
