Hypogonadism natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Natural History

• If left untreated, patients of hypogonadism will progress and end up with infertility.
• Untreated testosterone deficiency and hypogonadism have been linked with rheumatic autoimmune diseases as rheumatic arthritis and systemic lupus.
• They also show increase in the inflammatory markers as the following:
  • C reactive protein
  • Tumor necrosis factor
  • Interluekin 6

Complications

Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:

• Fetal life:
  • Ambigous genitalia which means genitalia unclear whether it is male or female.
• Puberty:
  • Gynecomastia
  • Complete delay of puberty
  • Impaired gonadal growth
• Adult:
  • Infertility
  • Type 2 Diabetes mellitus
  • Depression
  • Cardiovascular stroke
  • Myocardial infarction
  • Osteoporosis

Prognosis

• The prognosis of hypogonadism is good with treatment and patients can have normal life along side the appropriate medical therapy.
• Despite the different complications of hypogonadism, they can be managed under appropriate treatment.