Hypogonadism Flashcards
Define Hypogonadism
Clinical syndrome in males and females defined as the absence of sex hormones (testosterone/oestrogen/progesterone)
can be primary-related to testes / ovaries
Or secondary-related to Pit gland
Female hypogonadism is also referred as premature ovarian failure
Aetiology and risk factors of Hypogonadism
Men-
primary-defect in testes-
congenital-Kleinfelters
Acquired-trauma (torsion), infection, Drugs,
Secondary-Hypopituary, hyperprolactinoma, drugs, head injury
Females-
primary-
congenital-Tuners, ovarian dysgenesis, Congenital adrenal hyperplasia
Acquired-Medication, Radiotherapy, infection, surgery
2nd ary-hypopit, trauma, space occupying lesion, apoplexy
But 50% of cases of ovarian failure have no cause-idiopathic
Hypothyroidism can result in hypogonadism
Risk factors Age Prolactinoma FHX of ovarian failure FHX of AID T2DM in men
Epidiemology of Hypogonadism
Men-Increases with age. about 1/4 of US pop have low testo levels
2.1% of men in UK have hypogonadism
Female-1 in 250 women by age 35
1 in 100 by 40
Signs and Sx of hypogonadism
men-features of low testosterone
Female-features of low oestrogen
Men-decreased libdio, erectile dysfunction, no morning erection, infertility Gynacomastia Small testes lack of facial hair Hot flushes depression
bitemporal hemianopia and gallactorrhoae-prolactinoma
Female-Menopause symptoms Irregular periods Hot flushes, sleep issues, irritability Dry vagina, infertility increased BMI
signs of prolactinoma, signs of tuners, etc
Investigations of Hypogonadism
Men–total serum Testosterone-under 10.4 is considered hypogonadism
serum LH/FSH-indentify if primary (v high) or secondary (low)
Prolactin
PIT MRI
TSH-can result in hypogonadism
Female- Pregnancy test! LH/FSH --high in primary also high in menopause-repeat to avoid just being in cycle changes 2nd Ary -low AF
Estradiol levels-LOW
TSH-can be low if hypopit is cause
prolactin–should be normal
vaginal USS-small ovaries with minimal activity
