Male hypogonadism Flashcards
How do the signs and symptoms differ between pre-pubertal and post-pubertal onset of hypogonadism?
Pre-puberty
- small male sex organs (testes, penis and prostate)
- reduced body hair
- reduced bone and muscle mass
- high pitched voice
Post-puberty (less physical more physiological)
- low libido
- reduced no. of spontaneous erections
- less need to shave
- less energy/motivation
Define hypogonadism
Testosterone deficiency
When and how should testosterone be measured?
AM
Measure total testosterone + SHBG = free testosterone
How is hypogonadism managed?
Testosterone replacement therapy
- testosterone gel
- IM testosterone
When is testosterone replacement contradicted?
Hormonally responsive cancers e.g. breast and prostate
Why is testosterone gel not always best line of treatment?
If patient lives with others e.g. kids/females - they can also get extra testerone if they touch patient too soon
What is the difference between hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism?
Which is associated with primary and which with secondary causes of hypogonadism?
Hypergonadotrophic = High GnRH, LH and FSH
Primary
Hypogonadotrophic = Low GnRH, LH and FSH
Secondary
Klinefelter’s syndrome is a genetic condition which cannot be inherited. Explain why?
What is its typical karyotype?
47 XXY
It is caused by nondisjunction - a problem during mitosis
Patient presents with an isolted GnRH deficency and absent/deminished smell. What secondary cause of hypogonadism would you suspect?
Kallmann’s syndrome
What effect can eating disorders/excessive exercise have on male fertility?
Cause of secondary hypogonadism
How will a patient with Klinefelter’s syndrome look?
Male genitalia (small testes) More feminine body shape
What effect can haemochromatosis have on fertility?
Cause of primary hypogonadism
