Hypogonadism (Male)

Hypogonadism is a pathological condition caused by insufficient secretion of androgens or decreased sensitivity to them. This condition has various etiologies, including congenital underdevelopment of the gonads, toxic, infectious, radiation damage, as well as dysfunction of the hypothalamic-pituitary system.

With hypogonadism, there is a decrease in the secretion of sex hormones by the testes. In primary hypogonadism, the testicular tissue is directly affected; in secondary hypogonadism, hypofunction of the gonads occurs due to damage to the hypothalamic-pituitary system with a decrease in the gonadotropic function of the pituitary gland.

The clinical manifestations of hypogonadism depend on the age at which the disease began and the degree of androgen deficiency. There are pre-pubertal and post-pubertal forms. When the testicles are affected before puberty, a typical eunuchoid syndrome develops, which is characterized by high disproportionate growth due to delayed ossification of the epiphyseal growth zones, elongation of the limbs, underdevelopment of the chest and shoulder girdle. Skeletal muscles are poorly developed, subcutaneous fatty tissue is distributed according to the female type. True gynecomastia is not uncommon.

The skin with hypogonadism is pale. Poor development of secondary sexual characteristics: lack of hair on the face and body (on the pubis - female type), underdevelopment of the larynx, high voice. The genital organs are underdeveloped: the penis is small, the scrotum is formed, but depigmented, without folding, the testicles are hypoplastic, the prostate gland is underdeveloped, often not palpable.

With secondary hypogonadism, in addition to symptoms of androgen deficiency, obesity is often observed, and symptoms of hypofunction of other endocrine glands - the thyroid, adrenal cortex (the result of loss of pituitary tropic hormones) are common. Symptoms of panhypopituitarism may occur. Sexual desire and potency are absent.

If loss of testicular function occurs after puberty, when sexual development and the formation of the musculoskeletal system are already completed, the symptoms of the disease are less pronounced. Characterized by shrinkage of the testicles, decreased facial and body hair, thinning of the skin, poor muscle development, and often erectile dysfunction and ejaculation.

Various methods are used to diagnose hypogonadism, including measuring the level of gonadotropins and sex hormones in the blood, ultrasound examination of the genital organs, bone x-rays and other methods.

Treatment of hypogonadism depends on its etiology and the degree of androgen deficiency. In primary forms, it is possible to use androgen replacement therapy; secondary forms require correction of the function of the hypothalamic-pituitary system. Hypogonadism caused by a tumor may require surgical treatment.