Hypogonadism (male)

Hypogonadism (male) is a pathological condition caused by insufficient secretion of androgens.

Etiology - congenital maldevelopment of the sexual glands, toxic, infectious, radiation damage to them, a violation of the hypothalamic-pituitary system.

Pathogenesis - decreased secretion of sex hormones with testicles. In primary hypogonadism, directly affected by the tasticular tissue, in the secondary - the hypofunction of the sexual glands arises from the defeat of the hypothalamic-pituitary system with a decrease in the gonadotropic function of the pituitary gland.

Symptoms, course. Clinical manifestations depend on the age at which the disease occurred and the degree of androgen deficiency. Distinguish and postpubertate forms of hypogonadism are distinguished. With the defeat of the testes before puberty, a typical eunuchoid syndrome develops, high disproportionate growth is noted due to retardation of the ossification of the epiphyseal growth zones, lengthening of the extremities, underdevelopment of the thorax and the shoulder girdle. The skeletal musculature is poorly developed, the subcutaneous fatty tissue is distributed according to the female type. It is often true gynecomastia. The skin is pale. Weak development of secondary ponovyh signs: lack of hair on the face and body (on the pubic - according to the female type), underdevelopment of the larynx, high voice. Genital organs are underdeveloped: the penis is small, the scrotum is formed, but depigmented, without folding, the testes are hypoplastic, the prostate gland is underdeveloped, it is not often palpable to determine.

In secondary hypogonadism, in addition to the symptoms of androgen deficiency, obesity is often observed, hypofunction symptoms of other endocrine glands - thyroid, adrenal cortex (the result of the loss of tropic hormones of the pituitary gland) are not uncommon. Symptoms of panhypopituitarism may be observed. Sexual desire and potency are absent.

If the loss of function of the testicles occurred after puberty, when sexual development and the formation of the musculoskeletal system are already completed, the symptoms of the disease are less expressed. Typical decrease in testes, decreased face and body hair, thinning of the skin and loss of its elasticity, development of obesity by female type, violation of sexual functions, infertility, vegetative-vascular disorders.

Diagnostics uses data from radiographic and laboratory studies. With hypogonadism, which developed before puberty, there is a lagging behind the "bone" age from the passport age for several years. The testosterone content in the blood is below normal. In the case of primary hypogonadism, an increase in the level of gonadotropins in the blood, in the secondary hypogonadism, in some cases their content may be within the normal range. Urinary excretion of 17-CS may be within or below normal. When analyzing the ejaculate - azo or oligospermia; In some cases, ejaculate can not be obtained.

The prognosis for life is favorable. The disease is chronic, during treatment it is possible to reduce the symptoms of androgen insufficiency.

Treatment: substitution therapy with testosterone preparations (testosterone propionate, testanate, tetrasterone, sustanon-250, omnadren-250). In view of the substitution nature of treatment, it is carried out constantly.

With secondary hypogonadism, stimulating therapy with chorionic gonadotropin is prescribed for 1500-3000 ED 2-3 times a week by courses per month with monthly interruptions or with therapy with chorionic gonadotropin in combination with androgens.

Shows general tonic therapy, exercise therapy.