Primary Gonadal Failure

Question 1

What is Primary Gonadal Failure?

Answer 1

The term primary gonadal failure includes impairment of the Leydig cell, Sertoli cell and germ cell systems in the testis, and impairment of the theca/granulosa cell unit and germ cell systems in the ovaries.

Low androgen (e.g., testosterone) levels are referred to as hypoandrogenism and low estrogen (e.g., estradiol) as hypoestrogenism. These are responsible for the observed signs and symptoms. Hypogonadism can decrease other hormones secreted by the gonads including progesterone, DHEA, anti-Müllerian hormone, activin, and inhibin.

Question 2

Infertility in Primary Gonadal Failure

Answer 2

Sperm development (spermatogenesis) and release of the egg from the ovaries (ovulation) may be impaired by hypogonadism, which, depending on the degree of severity

Question 3

Causes of primary hypogonadism

Answer 3

Hypogonadism resulting from defects of the gonads is traditionally referred to as “primary hypogonadism”. Examples include Klinefelter syndrome and Turner syndrome. Mumps is known to cause testicular failure, and in recent years has been immunized against in the US. A varicocele can reduce hormonal production as well.

Question 4

Signs and Symptoms

Answer 4

Women with hypogonadism do not begin menstruating and it may affect their height and breast development. Onset in women after puberty causes cessation of menstruation, lowered libido, loss of body hair, and hot flashes. In men it causes impaired muscle and body hair development, gynecomastia, decreased height, erectile dysfunction, and sexual difficulties. If hypogonadism is caused by a disorder of the central nervous system (e.g., a brain tumor), then this is known as central hypogonadism. Signs and symptoms of central hypogonadism may involve headaches, impaired vision, double vision, milky discharge from the breast, and symptoms caused by other hormone problems.