Hypogonadism Dr.Chang

Question 1

What are the two types of hypogonadism

Answer 1

Primary and secondary hypogonadism

Question 2

What is the cause of primary hypogonadism

Answer 2

Problem with the testes or ovaries

Question 3

what is the cause of secondary hypogonadism

Answer 3

Problem with the hypothalamus or pituitary

Question 4

Testosterone levels decrease in men as they ________?

Answer 4

age

Question 5

what is the most common reason for hypogonadism in women?

Answer 5

Menopause

Question 6

what are the main medications that cause hypogonadism ?

Answer 6

1. opioids (methadone)
2. Chemotherapy
3. Cimetidine
   4.Spirnolactone

Question 7

What can hypogonadism in men lead to?

Answer 7

Osteoporosis, infertility, ED, decreased libido

Question 8

what can hypogonadism in women lead to ?

Answer 8

infertility, hot flashes, vaginal dryness, and irritability as estrogen levels fall, risk for osteoporosis and heart disease increase

Question 9

Hypogonadism in male leads to which one or two of the major function of the testes?

Answer 9

Decrease in sperm production
or
Decrease in testosterone or
Both

Question 10

what type of hypogonadism is it if LH and FSH concentrations are above normal?

Answer 10

primary

Question 11

What type of hypogonadism is it if LH and FSH are normal or low

Answer 11

secondary

Question 12

what is eunuchoidism and when is it seen?

Answer 12

features of sparse body hair, poor development of skeletal muscle, delay in epiphyseal closure resulting in long arms and legs.
Seen in hypogonadism before the onset of puberty

Question 13

What are the symptoms of hypogonadism in adults

Answer 13

low libido, decreased morning erections, loss of body hair, low bone mineral density, gynecomastia, and small testes

Question 14

what are common but non specific symptoms of hypogonadism

Answer 14

fatigue, depression, anemia, reduce muscle strength, and increased fat mass

Question 15

what is the normal range of testosterone ?

Answer 15

300-1,000 ng/dL

Question 16

what time of day should the total testosterone be checked?

Answer 16

between 8-10 am (fasting)

Question 17

When would you do a lab test of LH and FSH in hypogonadism ?

Answer 17

those pursuing fertility or those with known infertility

Question 18

what is the primary test for hypogonadism ?

Answer 18

Total testosterone

Question 19

what are additional lab test for hypogonadism ?

Answer 19

Prolactin, T4 (thyroxine), cortisol, Fe, transferrin, MRI, genetic test

Question 20

what is the MOA of testosterone ?

Answer 20

Direct binding to androgen receptor –> Converison of DHT by 5 alpha reductase or conversion of estradiol by aromatase

Question 21

what is the only indication for testosterone therapy?

Answer 21

Testosterone should only be given to a man who is hypogonadal

Question 22

what is the goal of testosterone therapy ?

Answer 22

restore testosterone to a normal range

Question 23

Can testosterone be used to increase spermatogenesis ?

Answer 23

No, in fact testosterone therapy may further impair spermatogenesis by suppressing pituitary gonadotropin secretion