Hypogonadism: Difference between revisions

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Latest revision as of 17:38, 14 September 2017

For patient information click here

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

Synonyms and keywords:Gonadal failure, Testosterone deficiency, Idiopathic hypogonadotropic hypogonadism

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypogonadism from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

External links

NIH

Template:WikiDoc Sources

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 '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
-{{CMG}}
+{{CMG}}; {{AE}} {{AEL}}
-{{SK}} Low T
+{{SK}}Gonadal failure, Testosterone deficiency, Idiopathic hypogonadotropic hypogonadism
-== Overview ==
+==[[Hypogonadism overview|Overview]]==
-'''Hypogonadism''' is a medical term for a defect of the [[reproductive system]] which results in lack of function of the [[gonad]]s ([[ovary|ovaries]] or [[testis|testes]]). The gonads have two functions: to produce [[hormone]]s ([[testosterone]], [[estradiol]], [[antimullerian hormone]], [[progesterone]], [[inhibin|inhibin B]]), [[activin]] and to produce [[gamete]]s ([[Ovum|egg]]s or [[Spermatozoon|sperm]]). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature [[menopause]]) in adults. Defective egg or sperm development results in [[infertility]].  The term hypogonadism is usually applied to permanent rather than transient or reversible defects, and usually implies deficiency of reproductive hormones, with or without [[fertility]] defects. The term is less commonly used for infertility without hormone deficiency.
-==Classification==
+==[[Hypogonadism historical perspective|Historical Perspective]]==
-There are many possible types of hypogonadism and several ways to categorize them.
+==[[Hypogonadism classification|Classification]]==
-===by Congenital vs. acquired===
+==[[Hypogonadism pathophysiology|Pathophysiology]]==
-* An example of [[congenital]] hypogonadism (present at birth) is [[Turner syndrome]].
-* An example of [[acquired]] hypogonadism (develops in childhood or adult life) is [[castration]].
-===by Hormones vs. fertility===
+==[[Hypogonadism causes|Causes]]==
-Hypogonadism can involve just [[hormone]] production or just [[fertility]], but most commonly involves both.
-* Examples of hypogonadism that affect hormone production more than fertility are [[hypopituitarism]] and [[Kallmann syndrome]]; in both cases fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement.
-* Examples of hypogonadism that affect fertility more than hormone production are [[Klinefelter syndrome]] and [[Kartagener syndrome]].
-===by Affected system===
+==[[Hypogonadism differential diagnosis|Differentiating Hypogonadism from other Diseases]]==
-Hypogonadism is also categorized by endocrinologists by the level of the reproductive system which is defective.
-*Hypogonadism resulting from defects of the [[gonads]] is traditionally referred to as '''primary hypogonadism'''. Examples include [[Klinefelter syndrome]] and [[Turner syndrome]].
+==[[Hypogonadism epidemiology and demographics|Epidemiology and Demographics]]==
-*Hypogonadism resulting from [[hypothalamic]] or [[pituitary]] defects are termed  '''secondary hypogonadism''' or '''central hypogonadism''' (referring to the [[central nervous system]]).
+==[[Hypogonadism risk factors|Risk Factors]]==
-**Examples of [[hypothalamus|Hypothalamic]] defects include [[Kallmann syndrome]]
-**Examples of [[pituitary gland|Pituitary]] defects include [[hypopituitarism]]
-*An example of a hypogonadism resulting from hormone response is [[androgen insensitivity syndrome]]
+==[[Hypogonadism natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-==Symptoms==
-Low Testosterone (Low T) symptoms include loss of energy, fatigue, loss of libido, muscle mass decline, decreased positive mood factors and an increased negative mood factors.
 ==Diagnosis==
-Low Testosterone can be identified through a simple blood test performed by a physician.  Normal testosterone levels range from 298 - 1098 ng/dl.  Physicians measure [[gonadotropin]]s ([[luteinizing hormone|LH]] and [[follicle stimulating hormone|FSH]]) to distinguish primary from secondary hypogonadism. In primary hypogonadism the LH and/or FSH are usually elevated, while in secondary hypogonadism both are normal or low.
+[[Hypogonadism history and symptoms|History and Symptoms]] | [[Hypogonadism physical examination|Physical Examination]] | [[Hypogonadism laboratory findings|Laboratory Findings]] | [[Hypogonadism CT|CT]] | [[Hypogonadism MRI|MRI]] | [[Hypogonadism echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Hypogonadism other imaging findings|Other Imaging Findings]] | [[Hypogonadism other diagnostic studies|Other Diagnostic Studies]]
-Hypogonadism is often discovered during evaluation of [[delayed puberty]], but ordinary delay which eventually results in normal [[puberty|pubertal]] development and reproductive function is termed.
 ==Treatment==
-Hypogonadism is most often treated by replacement of the appropriate hormones. For men this is [[testosterone]]. Commonly used testosterone formulations include  transdermal testosterone, injectable testosterone, and buccal testosterone. Oral testosterone is no longer used in the U.S. because it is broken down in the liver and rendered inactive.
+[[Hypogonadism medical therapy|Medical Therapy]] | [[Hypogonadism surgery|Surgery]] | [[Hypogonadism primary prevention|Primary Prevention]] | [[Hypogonadism secondary prevention|Secondary Prevention]] |  [[Hypogonadism cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hypogonadism future or investigational therapies|Future or Investigational Therpies]]
-Another feasible alternative is [[hCG]].
-For women [[estradiol]] and [[progesterone]] are replaced. Some types of fertility defects can be treated; some cannot.
-==References==
+==Case Studies==
-{{Reflist|2}}
+[[Hypogonadism case study one|Case #1]]
 ==External links==
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-[[de:Hypogonadismus]]
 [[es:Hipogonadismo]]
 [[fr:Hypogonadisme]]
 [[pt:Hipogonadismo]]
-[[fi:Hypogonadismi]]
 [[zh:性腺功能低下症]]
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 [[Category:Endocrinology]]
-[[Category:Signs and symptoms]]
 [[Category:Disease]]
 [[Category:Urologic Surgery]]
 [[Category:Gynecology]]

v t e Endocrine pathology: endocrine diseases (E00-35, 240-259)
Thyroid	Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome
Pancreas	Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome - insulin receptor (Rabson-Mendenhall syndrome)
Parathyroid	Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary)
Pituitary	Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease / Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome - Hypophysitis
Adrenal	Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (Lipoid, 3β, 11β, 17α, 21α) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism
Gonads	Ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - Testicular dysfunction (5-alpha-reductase deficiency) - Testosterone biosynthesis (17-beta-hydroxysteroid dehydrogenase deficiency) - General (Hypogonadism, Delayed puberty, Precocious puberty)
Other	Androgen insensitivity syndrome - Autoimmune polyendocrine syndrome - Carcinoid syndrome - Gigantism - Short stature (Laron syndrome, Psychogenic dwarfism) - Multiple endocrine neoplasia (1, 2) - Progeria - Woodhouse-Sakati syndrome