Hypogonadism

Question 1

What are the clinical signs of female hypogonadism pre-pubertally?

Answer 1

1. delayed menarche
2. short stature
3. lack of breast development

Question 2

What are the clinical signs of female hypogonadism post-pubertally?

Answer 2

1. cessation of menses/infertility
2. decrease in bone density/osteoporosis
3. vaginal dryness
4. hot flashes
5. insomnia

Question 3

What is hypergonadotropic hypogonadism?

Answer 3

No estrogen/testosterone produced so LH & FSH are high (not being inhibited)

Question 4

What is hypogonadotropic hypogonadism?

Answer 4

Pituitary problem - low LH & FSH, therefore no estrogen/testosterone

Question 5

What is a congenital cause of hypergonadotropic hyponadism in females?

Answer 5

Turner Syndrome

Question 6

What are three causes of hypogonadotropic hypogonadism in females?

Answer 6

1. excessive exercise/eating disorders
2. CNS tumors
3. Autoimmune disease

Question 7

If your physical exam reveals a highly arched palate and a webbed neck in a pubescent female with no breast development and short stature, what are you thinking?

Answer 7

Turner Syndrome

Question 8

What are the clinical signs of male hypogonadism pre-pubertally?

Answer 8

1. small genitalia
2. long extremities
3. lack of facial & chest hair
4. low libido/lack of sperm/ejaculate
5. low muscle mass
6. gynecomastia
7. higher-pitched voice

Question 9

What are the clinical signs of male hypogonadism post-pubertally?

Answer 9

1. infertility/azoospermia
2. decreased male-pattern hair growth
3. decreased libido or erectile dysfunction
4. decreased muscle mass
5. gynecomastia
6. fatigue
7. depression

Question 10

What childhood infection can cause male hypergonadotropic hypogonadism?

Answer 10

mumps

Question 11

What does Klinefelter Syndrome cause?

Answer 11

hypergonadotropic hypogonadism

Question 12

What are some contraindications of testosterone treatment?

Answer 12

Prostate cancer (BPH – relative)
Breast cancer
Erythrocytosis (HCT >50%)
Unstable class III/IV CHF

Question 13

What are some side effects of testosterone treatment?

Answer 13

1. prostate growth
2. erythrocytosis
3. acne
4. gynecomastia
5. decreased HDL
6. reduced sperm production
7. potential worsening of sleep apnea

Question 14

The treatment for male infertility is testosterone.

T/F

Answer 14

False.

Giving testosterone will inhibit LH/FSH production, which will inhibit sperm growth.

Question 15

What monitoring is necessary when treating a patient with testosterone?

Answer 15

1. testosterone levels
2. bone density prior to starting and after 1 year of therapy
3. prior, 3 & 6 months, and every year after: CBC, prostate exam, PSA, lipids