What is Hypogonadism?
Hypogonadism is when the sex glands produce little or no hormones. In men, these glands (gonads) are the testes; in women, they are the ovaries.
The cause of hypogonadism?
The cause of hypogonadism may be "primary" or "central." In primary hypogonadism, the ovaries or testes themselves do not function properly. Some causes of primary hypogonadism include:
- Surgery
- Radiation
- Genetic and developmental disorders
- Liver and kidney disease
- Infection
- Certain autoimmune disorders
The most common genetic disorders that cause primary hypogonadism are Turner syndrome (in women) and Klinefelter syndrome (in men).
In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Some causes of central hypogonadism include
- Tumors
- Surgery
- Radiation
- Infections
- Trauma
- Bleeding
- Genetic problems
- Nutritional deficiencies
- Iron excess (hemochromatosis)
A genetic cause of central hypogonadism that also produces an inability to smell is Kallmann syndrome (males). The most common tumors affecting the pituitary area are craniopharyngioma (in children) and prolactinoma (in adults).
The Symptoms of hypogonadism?
In girls, hypogonadism during childhood will result in lack of menstruation and breast development and short height. If hypogonadism occurs after puberty, symptoms include loss of menstruation, low libido, hot flashes, and loss of body hair.
In boys, hypogonadism in childhood results in lack of muscle and beard development and growth problems. In men the usual complaints are sexual dysfunction, decreased beard and body hair, breast enlargement, and muscle loss.
If a brain tumor is present (central hypogonadism) there may be headaches or visual loss, or symptoms of other hormonal deficiencies (such as hypothyroidism). In the case of the most common pituitary tumor, prolactinoma, there may be a milky breast discharge. People with anorexia nervosa (excessive dieting to the point of starvation) also may have central hypogonadism.
The treatment of hypogonadism?
Hormone-based medicines are available for men and women. Estrogen comes in the form of a patch or pill. Testosterone can be given by using a patch, a product soaked in by the gums, a gel, or by injection.
For women who have not had their uterus removed, combination treatment with estrogen and progesterone is often recommended to decrease the chances of developing endometrial cancer. In addition, low dose testosterone can be added for women with hypogonadism who have a low sex drive.
In some women, injections or pills can be used to stimulated ovulation. Injections of pituitary hormone may be used to help male patients produce sperm. In others, surgery and radiation therapy may be needed.
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