Hypogonadism

Hypogonadotropic hypogonadism is a genetically heterogeneous disorder characterized by infertility and... 

Hypogonadotropic hypogonadism Gonadotropin-releasing hormone (GnRH) receptor GnRH peptidomimetic antagonist... 

Chorionic gonadotropin (HCG) is extracted from human placentas. The actions of HCG are identical to those of the pituitary LH. The hormone is used to induce ovulation in anovulatory women. This drug is also used for the treatment of prepubertal cryptorchism (failure of the testes to descend into the scrotum) and in men to treat selected cases of hypogonadotropic hypogonadism. 

M ale and female hormones play a vital role because they aid in development and maintenance of secondary sex characteristics and are necessary for human reproduction. Although hormones are naturally produced by die body, administration of a male or female hormone may be indicated in the treatment of certain disorders, such as inoperable breast cancer, male hypogonadism, and male or female hormone deficiency. Hormones also are used as contraceptives and for treating the symptoms of menopause... 

Quinton H.W., Grant W., Thrasivoulou C.Q. and Besser G.M. (1997). Gonadotropin-releasing hormone immunoreactivity in the nasal epithelia of adults with Kallmann s syndrome and isolated hypogonadotropic hypogonadism, in the early midtrimester human fetus. J Clin Endocrinol Metab 82, 309-314. 

Androgen replacement in male CF patients with documented hypogonadism may also benefit bone health but should be decided on an individual basis.10,27... 

Damage and destruction of the pituitary gland may result in secondary hypothyroidism, hypogonadism, adrenal insufficiency, growth hormone deficiency, hypoprolactinemia, or... 

Routinely assess acromegaly complications, including blood pressure, glucose tolerance, fasting lipid profile, cardiac evaluations (if clinically indicated), colonoscopy, dual-energy x-ray absorptiometry (DEXA) scan (hypogonadal only), evaluation of residual pituitary function, and evaluation of sleep apnea. 

Prolactin greater than 100 ng/mL (100 mcg/L) hypogonadism, galactorrhea, and amenorrhea... 

The degree of hypogonadism generally is proportionate to the degree of prolactin elevation. 

Consider a bone mineral density test in patients with long-term hypogonadism. Additional Clinical Sequelae... 

Because hyperprolactinemia is often associated with hypogonadism, the goals for management of hyperprolactinemia are to restore the clinical consequences of hypogonadism and reduce its associated risk for osteoporosis44 (Table 43-7). 

Endocrine disorders (hypogonadism and pituitary, adrenal, and thyroid disorders)... 

Androgens are important for general sexual function and libido, but testosterone supplementation is only effective in patients with documented low serum testosterone levels. In patients with hypogonadism, testosterone replacement is the initial treatment of choice, as it corrects decreased libido, fatigue, muscle loss, sleep disturbances, and depressed mood. Improvements in ED may occur, but they should not be expected to occur in all patients.23 The initial trial should be for 3 months. At that time, re-evaluation and the addition of another ED therapy is warranted. Routes of administration include oral, intramuscular, topical patches or gel, and a buccal tablet. 

Approximately one-third to one-half of osteoporosis cases in men and half of all cases in perimenopausal women are due to secondary causes.4 Common secondary causes in men include hypogonadism, glucocorticoid use, and alcoholism. The most common cause of drug-induced osteoporosis is glucocorticoid use. 

Because secondary osteoporosis causes play a significant role in men, any secondary cause (e.g., hypogonadism) should be excluded or treated before considering other drug therapy. 

Hypogonadism A condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development or reduced or absent secretion of hormones from the sex glands resulting in low testosterone levels in men. 

Spratt, D. I., Bigos, S. T., Beitins, I., Cox, P., Longcope, C., and Orav, J., Both hyper- and hy-pogonadotropic hypogonadism occur transiently in acute illness Bio- and immunoreactive gonadotropins. J. Clin. Endocrinol. Matab. 75,1562-1570 (1992). 

Braunstein GD, Dahlgren J, Loriaux DL. 1978. Hypogonadism in chronically lead-poisoned men. Infertility 1 33-51. 

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