Hypogonadism Dr.Chang Flashcards
What are the two types of hypogonadism
Primary and secondary hypogonadism
What is the cause of primary hypogonadism
Problem with the testes or ovaries
what is the cause of secondary hypogonadism
Problem with the hypothalamus or pituitary
Testosterone levels decrease in men as they ________?
age
what is the most common reason for hypogonadism in women?
Menopause
what are the main medications that cause hypogonadism ?
- opioids (methadone)
- Chemotherapy
- Cimetidine
4.Spirnolactone
What can hypogonadism in men lead to?
Osteoporosis, infertility, ED, decreased libido
what can hypogonadism in women lead to ?
infertility, hot flashes, vaginal dryness, and irritability as estrogen levels fall, risk for osteoporosis and heart disease increase
Hypogonadism in male leads to which one or two of the major function of the testes?
Decrease in sperm production
or
Decrease in testosterone or
Both
what type of hypogonadism is it if LH and FSH concentrations are above normal?
primary
What type of hypogonadism is it if LH and FSH are normal or low
secondary
what is eunuchoidism and when is it seen?
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
What are the symptoms of hypogonadism in adults
low libido, decreased morning erections, loss of body hair, low bone mineral density, gynecomastia, and small testes
what are common but non specific symptoms of hypogonadism
fatigue, depression, anemia, reduce muscle strength, and increased fat mass
what is the normal range of testosterone ?
300-1,000 ng/dL
what time of day should the total testosterone be checked?
between 8-10 am (fasting)
When would you do a lab test of LH and FSH in hypogonadism ?
those pursuing fertility or those with known infertility
what is the primary test for hypogonadism ?
Total testosterone
what are additional lab test for hypogonadism ?
Prolactin, T4 (thyroxine), cortisol, Fe, transferrin, MRI, genetic test
what is the MOA of testosterone ?
Direct binding to androgen receptor –> Converison of DHT by 5 alpha reductase or conversion of estradiol by aromatase
what is the only indication for testosterone therapy?
Testosterone should only be given to a man who is hypogonadal
what is the goal of testosterone therapy ?
restore testosterone to a normal range
Can testosterone be used to increase spermatogenesis ?
No, in fact testosterone therapy may further impair spermatogenesis by suppressing pituitary gonadotropin secretion
