Hypogonadism natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
If left untreated, patients with hypogonadism will end up with [[infertility]] and [[rheumatic]] [[autoimmune diseases|autoimmune diseas]]. These autoimmune disease include [[Rheumatoid arthritis|rheumatic arthritis]] and [[systemic lupus erythematosus]]. Complications of hypogonadism depend on age and include [[ambiguous genitalia]] in the newborn, [[gynecomastia]], and [[Delayed puberty|delay of puberty]] in the prepubertal phase. Complications also include [[depression]] and [[Stroke|cardiovascular stroke]] in the adults. [[Prognosis]] of hypogonadism is regarded as good for patients who receive treatment and can have a normal life with appropriate medical therapy.


==Natural History==
==Natural History==
* If left untreated, patients with hypogonadism will progress and end up with infertility.
* Untreated [[testosterone]] deficiency and hypogonadism have been linked with [[rheumatic]] [[autoimmune diseases]] as [[rheumatoid arthritis]] and  [[systemic lupus erythematosus]].<ref name="pmid27325124">{{cite journal| author=Baillargeon J, Al Snih S, Raji MA, Urban RJ, Sharma G, Sheffield-Moore M et al.| title=Hypogonadism and the risk of rheumatic autoimmune disease. | journal=Clin Rheumatol | year= 2016 | volume= 35 | issue= 12 | pages= 2983-2987 | pmid=27325124 | doi=10.1007/s10067-016-3330-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27325124  }}</ref>
* They also show an increase in the [[inflammatory]] markers as the following:
** [[C reactive protein]]
** [[Tumour necrosis factor|Tumor necrosis factor]]
** [[Interleukin 6]]


==Complications==  
==Complications==  
Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:<ref name="pmid23937088">{{cite journal| author=Arver S, Luong B, Fraschke A, Ghatnekar O, Stanisic S, Gultyev D et al.| title=Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden. | journal=J Sex Med | year= 2014 | volume= 11 | issue= 1 | pages= 262-72 | pmid=23937088 | doi=10.1111/jsm.12277 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937088  }} </ref>
Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:<ref name="pmid23937088">{{cite journal| author=Arver S, Luong B, Fraschke A, Ghatnekar O, Stanisic S, Gultyev D et al.| title=Is testosterone replacement therapy in males with hypogonadism cost-effective? An analysis in Sweden. | journal=J Sex Med | year= 2014 | volume= 11 | issue= 1 | pages= 262-72 | pmid=23937088 | doi=10.1111/jsm.12277 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937088  }} </ref>
* Fetal life:  
* Fetal life:  
** Ambigous genitalia which means genitalia unclear whether it is male or female.  
** [[Ambiguous genitalia]] which means [[genitalia]] unclear whether it is male or female.  
* Puberty:  
* Puberty:  
** Gynecomastia  
** [[Gynecomastia]]
** Complete delay of puberty
** [[Delayed puberty|Complete delay of puberty]]
** Impaired gonadal growth  
** Impaired [[gonadal]] growth  
* Adult:  
* Adult:  
** Infertility  
** [[Infertility]]
** Type 2 Diabetes mellitus
** [[Diabetes mellitus|Type 2 Diabetes mellitus]]
**Depression  
**[[Depression]]
**Cardiovascular stroke  
**[[Stroke|Cardiovascular stroke]]
**Myocardial infarction
**[[Myocardial infarction]]
**Osteoporosis
**[[Osteoporosis]]


==Prognosis==
==Prognosis==
* The prognosis of hypogonadism is good with treatment and patients can have normal life along side the appropriate medical therapy.
* The [[prognosis]] of hypogonadism is good with treatment and patients can have a normal life with the appropriate medical [[therapy]].<ref name="pmid24636400">{{cite journal| author=Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED| title=Anabolic steroid-induced hypogonadism: diagnosis and treatment. | journal=Fertil Steril | year= 2014 | volume= 101 | issue= 5 | pages= 1271-9 | pmid=24636400 | doi=10.1016/j.fertnstert.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24636400  }}</ref>
* Despite the different complications of hypogonadism, they can be managed under appropriate treatment.<ref name="pmid24636400">{{cite journal| author=Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED| title=Anabolic steroid-induced hypogonadism: diagnosis and treatment. | journal=Fertil Steril | year= 2014 | volume= 101 | issue= 5 | pages= 1271-9 | pmid=24636400 | doi=10.1016/j.fertnstert.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24636400  }}</ref>


==References==
==References==

Latest revision as of 18:01, 3 October 2017

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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 diseas. These autoimmune disease include rheumatic arthritis and systemic lupus erythematosus. Complications of hypogonadism depend on age and include ambiguous genitalia in the newborn, gynecomastia, and delay of puberty in the prepubertal phase. Complications also include depression and cardiovascular stroke in the adults. Prognosis of hypogonadism is regarded as good for patients who receive treatment and can have a normal life with appropriate medical therapy.

Natural History

Complications

Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:[2]

Prognosis

  • The prognosis of hypogonadism is good with treatment and patients can have a normal life with the appropriate medical therapy.[3]

References

  1. 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.
  2. 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.
  3. 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.

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