endocrine aspects of male hypogonadism

Question 1

What are the 2 anatomical units of the testes

Answer 1

Seminiferous tubules in which inhibin B and anti-mullerian hormone are made by Sertoli cells and sperm are produced

an interstitium containing Leydig cells that produce androgens and myoid cells.

Question 2

What is the role of LH and FSH in the testicular hp axis

Answer 2

LH is involved in the release of testosterone

FSH is involved in spermatogenesis and inhibin B secretion

Question 3

What is male hypogonadism

Answer 3

Decrease in one or both of the 2 major functions of the testes which is sperm production and testosterone production

Question 4

What is primary m hypogonadism

Answer 4

Testosterone below normal and serum LH and/or FSH are above normal

Question 5

What is secondary m hypogonadism

Answer 5

Testosterone is below normal and serum LH and/or FSH is normal or low

Question 6

What are the causes of Primary m hypogonadism

Answer 6

Klinefelter syndrome, cryptorchidism, idiopathic

infection-mump, radiation, trauma, torsion

Question 7

What are the causes of secondary m hypogonadism

Answer 7

Congenital GnRH deficiency, hyperprolactinaemia

GnRH analog, androgen, opioids, illness, anorexia nervosa and pituitary disorder

Question 8

What are the signs and symptoms of hypogonadism

Answer 8

Incomplete sexual development decreased sexual desire and activity, decreased body hair, shrinking testes, decreased muscle bulk and strength.

Question 9

What are some conditions with a high prevalence of hypogonadism

Answer 9

sellar mass, meds that affect T-production: opioids
HIV- associated weight loss
Moderate to Severe COPD
Type 2 diabetes mellitus

Question 10

What signs are you looking at in an exam for hypogonadism

Answer 10

amount of body hair
breast exam (enlarged or tender?)
size and consistency of testicles/ size of the penis
arm span

Question 11

What are some Inv for hypogonadism

Answer 11

Serum testosterone, LH/ FSH, LFT, Semen analysis, MRI, Pituitary function test, DEXA scan, SHGB

Question 12

What lowers SHBG

Answer 12

Moderate obesity, nephrotic syndrome, hypothyroidism, use of glucocorticoids

Question 13

What raises SHGB

Answer 13

Ageing, estrogens, HIV infection, hepatic cirrhosis

Question 14

What is the treatments for M-HypoG

Answer 14

Testosterone

• Gel
• Injection
• Buccal/ patch/ pellet

Question 15

What is Gynecomastia

Answer 15

benign proliferation of the glandular tissue of the male breast, may be uni/ bilateral

due to an imbalance between androgen/ estrogen
60% of boys during puberty
30-70% in adult men