Hypogonadism resident survival guide: Difference between revisions
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==Overview== | ==Overview== | ||
Hypogonadism is a disorder of the [[reproductive system]] which results in lack of function of the [[Gonad|gonads]] ([[Ovary|ovaries]] or [[Testis|testes]]). Hypogonadism is caused by several [[Diseases|conditions]] which may be [[congenital]], [[acquired]], [[genetic]], or [[malignancies]]. Hypogonadism may be classified on the basis of etiology and the site causing the defect into primary or secondary hypogonadism. Primary hypogonadism results from defect in the [[gonads]] themselves and it has a high level of the [[Gonadotropins|gonadotropin hormones]] [[FSH]] and [[LH]]. Secondary hypogonadism indicates a defect in the [[pituitary gland]] or the [[hypothalamus]] and presents with a low level of the [[Gonadotropin-releasing hormone|gonadotropin releasing hormone]], [[FSH]], and [[LH]]. Hypogonadism is also associated with low level of [[Testosterone|testosterone hormone]], especially in the males. [[Genetic mutations]] that can cause hypogonadism include ANOS 1, [[SOX10]], [[SEMA3A]], IL17RD and FEZF1. Other [[genes]] include KISS, GNRNH, and PROK. Hypogonadism must be differentiated from [[diseases]] that cause [[delayed puberty]] or [[infertility]]. The [[prevalence]] of hypogonadism is estimated to be 38,700 per 100,000 individual aging 45 years. The [[incidence]] of hypogonadism is 1230 per 100,000 persons. Hypogonadism affects men more than women and its [[prevalence]] increases with age. Hypogonadism has many risk factors like [[dyslipidemia]], [[obesity]], [[malignancies]] and [[alcohol]] intake. Screening may be done for men patients who present with [[erectile dysfunction]], [[infertility]], [[HIV]] patients and young patients with [[Osteoporosis (patient information)|osteoporosis]]. If left untreated, patients with hypogonadism will end up with [[infertility]] and [[rheumatic]] [[autoimmune diseases]]. Hypogonadism can cause complications like [[gynecomastia]] and [[Delayed puberty|delay of puberty]] in the prepubertal patients. It can also cause [[depression]] and [[Stroke|cardiovascular stroke]] in the adults. Hypogonadism usually has a good [[prognosis]] with the proper treatment. Patients with hypogonadism usually present with loss of the [[secondary sexual characteristics]]. Male patients present with [[infertility]], [[loss of libido]], and [[erectile dysfunction]]. Female patients present with [[amenorrhea]] and no [[pubic hair]]. Lab diagnosis reveals low [[testosterone]] levels, variable [[FSH]] and [[LH]] levels according to the cause of hypogonadism whether primary or secondary. The mainstay of treatment for hypogonadism is [[Testosterone|testosterone replacement therapy]] and it can be administrated through different regimens [[Testosterone (injection)|injected]], [[Testosterone (transdermal)|transdermal]] or [[Testosterone (buccal)|buccal]]. In females, [[estrogen]] replacement is helpful besides testosterone. | |||
==Causes== | ==Causes== | ||
Revision as of 14:29, 13 September 2017
Overview
Hypogonadism is a disorder of the reproductive system which results in lack of function of the gonads (ovaries or testes). Hypogonadism is caused by several conditions which may be congenital, acquired, genetic, or malignancies. Hypogonadism may be classified on the basis of etiology and the site causing the defect into primary or secondary hypogonadism. Primary hypogonadism results from defect in the gonads themselves and it has a high level of the gonadotropin hormones FSH and LH. Secondary hypogonadism indicates a defect in the pituitary gland or the hypothalamus and presents with a low level of the gonadotropin releasing hormone, FSH, and LH. Hypogonadism is also associated with low level of testosterone hormone, especially in the males. Genetic mutations that can cause hypogonadism include ANOS 1, SOX10, SEMA3A, IL17RD and FEZF1. Other genes include KISS, GNRNH, and PROK. Hypogonadism must be differentiated from diseases that cause delayed puberty or infertility. The prevalence of hypogonadism is estimated to be 38,700 per 100,000 individual aging 45 years. The incidence of hypogonadism is 1230 per 100,000 persons. Hypogonadism affects men more than women and its prevalence increases with age. Hypogonadism has many risk factors like dyslipidemia, obesity, malignancies and alcohol intake. Screening may be done for men patients who present with erectile dysfunction, infertility, HIV patients and young patients with osteoporosis. If left untreated, patients with hypogonadism will end up with infertility and rheumatic autoimmune diseases. Hypogonadism can cause complications like gynecomastia and delay of puberty in the prepubertal patients. It can also cause depression and cardiovascular stroke in the adults. Hypogonadism usually has a good prognosis with the proper treatment. Patients with hypogonadism usually present with loss of the secondary sexual characteristics. Male patients present with infertility, loss of libido, and erectile dysfunction. Female patients present with amenorrhea and no pubic hair. Lab diagnosis reveals low testosterone levels, variable FSH and LH levels according to the cause of hypogonadism whether primary or secondary. The mainstay of treatment for hypogonadism is testosterone replacement therapy and it can be administrated through different regimens injected, transdermal or buccal. In females, estrogen replacement is helpful besides testosterone.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Diagnosis
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Treatment
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Do's
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Don'ts
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