Hypogonadism natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, patients with hypogonadism will end up with infertility and rheumatic autoimmune diseases. These autoimmune diseases include rheumatic arthritis and lupus. Complications of hypogonadism depend on age and include | If left untreated, patients with hypogonadism will end up with [[infertility]] and [[rheumatic]] [[autoimmune diseases]]. These autoimmune diseases include [[Rheumatoid arthritis|rheumatic arthritis]] and [[systemic lupus erythematosus]]. Complications of hypogonadism depend on age and include [[ambiguous genitalia]] in the new born, [[gynecomastia]], and [[Delayed puberty|delay of puberty]] in the prepubertal phase. Complications include also [[depression]] and [[Stroke|cardiovascular stroke]] in the adults. Prognosis of hypogonadism is good with treatment and patients can have a normal life along side the appropriate medical therapy. | ||
==Natural History== | ==Natural History== | ||
* If left untreated, patients | * If left untreated, patients with hypogonadism will progress and end up with infertility. | ||
* Untreated testosterone deficiency and hypogonadism have been linked with rheumatic autoimmune diseases as | * Untreated [[testosterone]] deficiency and hypogonadism have been linked with [[rheumatic]] [[autoimmune diseases]] as [[rheumatoid arthritis]] and [[systemic lupus erythematosus]].<ref name="pmid27325124">{{cite journal| author=Baillargeon J, Al Snih S, Raji MA, Urban RJ, Sharma G, Sheffield-Moore M et al.| title=Hypogonadism and the risk of rheumatic autoimmune disease. | journal=Clin Rheumatol | year= 2016 | volume= 35 | issue= 12 | pages= 2983-2987 | pmid=27325124 | doi=10.1007/s10067-016-3330-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27325124 }}</ref> | ||
* They also show increase in the inflammatory markers as the following: | * They also show an increase in the [[inflammatory]] markers as the following: | ||
** C reactive protein | ** [[C reactive protein]] | ||
** Tumor necrosis factor | ** [[Tumour necrosis factor|Tumor necrosis factor]] | ||
** | ** [[Interleukin 6]] | ||
==Complications== | ==Complications== | ||
Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:<ref name="pmid23937088">{{cite journal| author=Arver S, Luong B, Fraschke A, Ghatnekar O, Stanisic S, Gultyev D et al.| title=Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden. | journal=J Sex Med | year= 2014 | volume= 11 | issue= 1 | pages= 262-72 | pmid=23937088 | doi=10.1111/jsm.12277 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937088 }} </ref> | Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:<ref name="pmid23937088">{{cite journal| author=Arver S, Luong B, Fraschke A, Ghatnekar O, Stanisic S, Gultyev D et al.| title=Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden. | journal=J Sex Med | year= 2014 | volume= 11 | issue= 1 | pages= 262-72 | pmid=23937088 | doi=10.1111/jsm.12277 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937088 }} </ref> | ||
* Fetal life: | * Fetal life: | ||
** | ** [[Ambiguous genitalia]] which means [[genitalia]] unclear whether it is male or female. | ||
* Puberty: | * Puberty: | ||
** Gynecomastia | ** [[Gynecomastia]] | ||
** Complete delay of puberty | ** [[Delayed puberty|Complete delay of puberty]] | ||
** Impaired gonadal growth | ** Impaired [[gonadal]] growth | ||
* Adult: | * Adult: | ||
** Infertility | ** [[Infertility]] | ||
** Type 2 Diabetes mellitus | ** [[Diabetes mellitus|Type 2 Diabetes mellitus]] | ||
**Depression | **[[Depression]] | ||
**Cardiovascular stroke | **[[Stroke|Cardiovascular stroke]] | ||
**Myocardial infarction | **[[Myocardial infarction]] | ||
**Osteoporosis | **[[Osteoporosis]] | ||
==Prognosis== | ==Prognosis== | ||
* The prognosis of hypogonadism is good with treatment and patients can have normal life along side the appropriate medical therapy. | * The prognosis of hypogonadism is good with treatment and patients can have a normal life along side the appropriate medical therapy. | ||
* Despite the different complications of hypogonadism, they can be managed under appropriate treatment.<ref name="pmid24636400">{{cite journal| author=Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED| title=Anabolic steroid-induced hypogonadism: diagnosis and treatment. | journal=Fertil Steril | year= 2014 | volume= 101 | issue= 5 | pages= 1271-9 | pmid=24636400 | doi=10.1016/j.fertnstert.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24636400 }}</ref> | * Despite the different complications of hypogonadism, they can be managed under appropriate treatment.<ref name="pmid24636400">{{cite journal| author=Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED| title=Anabolic steroid-induced hypogonadism: diagnosis and treatment. | journal=Fertil Steril | year= 2014 | volume= 101 | issue= 5 | pages= 1271-9 | pmid=24636400 | doi=10.1016/j.fertnstert.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24636400 }}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
If left untreated, patients with hypogonadism will end up with infertility and rheumatic autoimmune diseases. These autoimmune diseases include rheumatic arthritis and systemic lupus erythematosus. Complications of hypogonadism depend on age and include ambiguous genitalia in the new born, gynecomastia, and delay of puberty in the prepubertal phase. Complications include also depression and cardiovascular stroke in the adults. Prognosis of hypogonadism is good with treatment and patients can have a normal life along side the appropriate medical therapy.
Natural History
- If left untreated, patients with hypogonadism will progress and end up with infertility.
- Untreated testosterone deficiency and hypogonadism have been linked with rheumatic autoimmune diseases as rheumatoid arthritis and systemic lupus erythematosus.[1]
- They also show an increase in the inflammatory markers as the following:
Complications
Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:[2]
- Fetal life:
- Ambiguous genitalia which means genitalia unclear whether it is male or female.
- Puberty:
- Gynecomastia
- Complete delay of puberty
- Impaired gonadal growth
- Adult:
Prognosis
- The prognosis of hypogonadism is good with treatment and patients can have a normal life along side the appropriate medical therapy.
- Despite the different complications of hypogonadism, they can be managed under appropriate treatment.[3]
References
- ↑ Baillargeon J, Al Snih S, Raji MA, Urban RJ, Sharma G, Sheffield-Moore M; et al. (2016). "Hypogonadism and the risk of rheumatic autoimmune disease". Clin Rheumatol. 35 (12): 2983–2987. doi:10.1007/s10067-016-3330-x. PMID 27325124.
- ↑ Arver S, Luong B, Fraschke A, Ghatnekar O, Stanisic S, Gultyev D; et al. (2014). "Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden". J Sex Med. 11 (1): 262–72. doi:10.1111/jsm.12277. PMID 23937088.
- ↑ Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED (2014). "Anabolic steroid-induced hypogonadism: diagnosis and treatment". Fertil Steril. 101 (5): 1271–9. doi:10.1016/j.fertnstert.2014.02.002. PMID 24636400.