General characteristics of the disease
Hypogonadism in males - a disease caused by deficiency of hormone-androgen. Depending on the etiology of the disease to distinguish between primary and secondary hypogonadism form of the disease (it - hypogonadotropic hypogonadism). The primary form of the disease characterized by elevated levels of gonadotropin-releasing hormone in the body, often called hypergonadotrophic hypogonadism.
Pathology is a leader on the prevalence among male diseases caused functional deficiency sex glands.
Primary hypogonadism in males
Primary hypogonadism may be innate. The disease manifests testicular testicular failure or a complete lack of (anorchia). The pathology manifests itself even during the prenatal period. The boy was born with a penis, whose size is much smaller than normal, as well as underdeveloped scrotum.
Further symptoms of congenital primary hypogonadism forms appear during adolescence. Young men with primary hypogonadism have a so-called "eunuchoid" type skeleton overweight, signs of gynecomastia (breast enlargement), a small degree of body hair.
Congenital primary hypogonadism - a frequent phenomenon in the genetic syndrome Klinefelter, Reyfenshteyna, Turner, Noonan and Del Castillo.
Primary hypogonadism in males may also be acquired. It is this form of the disease is the most common and occurs at an average of one in five men diagnosed with infertility.
Acquired primary hypogonadism is caused by inflammation of the testes in case of:
- orchitis (inflammation of the testicles)
- vesicles (inflammation of the seminal vesicles)
- trim (inflammation of the spermatic cord)
- epididymitis (inflammation of the epididymis)
- infectious parotitis (mumps)
A possible precipitating factor acquired primary hypogonadism and cryptorchidism is considered (undescended testicles into the scrotum). Provoke functional deficiency sex glands, men can injury or radiation injury of the testicles.
It is also possible idiopathic form of primary hypogonadism in men with unknown etiology of the disease.
If your purchased primary hypogonadism in teens is no formation of secondary sexual characteristics. In adult men, the disease leads to weight gain, decreased libido, erectile dysfunction and spermatogenesis, to a decrease of expression of male sexual characteristics, and infertility.
Secondary hypogonadism in males
Secondary hypogonadotropic hypogonadism, or it can also be congenital. It occurs in disorders of hormone secretion by the pituitary gland and the hypothalamus. Secondary hypogonadism accompanies these genetic diseases:
- Pasqualini's syndrome,
- Maddock's syndrome,
- Prader-Willi syndrome.
Hypogonadotropic hypogonadism development - is also not uncommon when craniopharyngioma (epithelial tumors of the brain).
Acquired secondary hypogonadism is caused by complications of inflammatory processes in the brain. They can trigger meningitis, arachnoiditis, meningoencephalitis, encephalitis, etc.
If you are suffering not only a function of sex glands, but there are other diseases of the hypothalamic-pituitary system: disorders of the thyroid gland secretion, thermoregulation, weight and linear growth.
Diagnosis of hypogonadism in men
Congenital primary hypogonadism is diagnosed if a newborn boy can not be felt on palpation of the testes. To confirm the diagnosis applied pelvic ultrasound and hormone blood tests.
Characteristic features of the disease are indicators of below-normal testosterone levels, high levels of luteinizing hormone and follicle-stimulating hormone in primary hypogonadism and deficiency of the above hormones in hypogonadotropic hypogonadism.
In the diagnosis of secondary hypogonadism in men used CT, MRI and EEG of the brain.
To clarify the causes of hypogonadism primary or secondary forms of the differential diagnosis is carried out genetic disease.
Treatment of hypogonadism in males
In the treatment of hypogonadism replacement therapy applied male sexual hormones. When lifelong continuous administration of the drug, since adolescence, the boy formed secondary sexual characteristics. In most cases also manages to retain sexual function.
The treatment of hypogonadism, cryptorchidism provoked mainly surgical. Recommended age surgery - 1-1, 5 years. The higher the undescended testicle in the abdominal area, the sooner there are irreversible processes in the tissues of the seminal glands. They lead to the acquired primary hypogonadism and infertility.
Treatment of hypogonadotropic hypogonadism form of therapy is the main disease. Surgery or radiation therapy hypogonadism held with brain tumors.
The strategy of substitution treatment of hypogonadism secondary forms depends on the extent of violations of hormone of the hypothalamic-pituitary system and the patient's age.
If there is no need to keep spermoobrazuyuschuyu function of the patient, the treatment of hypogonadism hypogonadotropic form is carried out by testosterone.
Young men and adolescent boys used a short course of testosterone therapy, and to normalize spermatogenesis hypogonadotropic hypogonadism when used drugs gonadotropins.