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]
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 ambigous 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 normal life along side the appropriate medical therapy.
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.[1]
- 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:[2]
- 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.[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.