Hypogonadism Flashcards
What cells produce testosterone and sperm
Testosterone = leydig cells between seminiferous tubules that produce sperm
What HPA hormones stimulate testosterone production
Hypothalamus produces gonadotropin releasing hormone which acts on the pituitary to stimulate lutenizing and follicle stimulating hormone
Two classification or types of hypogonadism
Primary - problem with the testes
low testosterone but high LH and FSH
Secondary - problem with HPA axis
Low testosterone and LOW LH and FSH
Some causes of primary hypogonadism
Kliendelter syndrome Undescended testes Mumps orchitis Hemochromatosis Injury to the testes Cancer treatment Normal Aging
Some causes of secondary hypogonadism
Kallmann Syndrome Pituitary disorder HIV/AIDS Inflammatory disease Medications - GC Obesity Stress induced hypogonadism
Clinical features of a typical hypogonadism patient
Low energy/fatigue Reduced muscle mass and strength Low libido Erectile dysfunction Gynaecomastia Reduced testes size <5 ml Lack of hair or changes to hair distribution
Investigations for hypogonadism
Total serum testosterone - measured between 6-8 am <9.7-10.4 Pituitary hormones - LH and FSH Serum sex hormone binding globulin (SHBG) if testosterone borderline Iron studies for anaemia Prolactin for hyperprolactemia Genetic testing Iron studies Thyroid Stimulating Hormone
Differential diagnosis of hypogonadism
Diabetes Depression Cushing's Prolactinoma Hyperprolactinaemia Pituitary Adenoma
Complications associated with hypogonadism
Osteoporosis
Metabolic syndrome - inc glucose intolerance
Infertility
Central obesity
