Hypogonadism

Hypogonadism is the condition where in there is considerable reduced or completely no production of testosterone– the sex hormone by the gonads ie the testicles in the male reproductive system. This in turn reduces the quantity and quality of the sperms produced.

Types and Causes:

Primary Hypogonadism:

  • Gonad disorders cause lack of sex hormones.
  • Liver and kidney infection/ diseases.
  • Previous surgery in the reproductive system area.
  • Side effect of certain medications.
  • Autoimmune disorders: Addison’s disease/ hypoparathyroidism.
  • Hereditary disorders: Klinefelter syndrome/ Turner syndrome.
  • High iron absorption in the body- Hemochromatosis.
  • Radiation treatment.

Central Hypogonadism: Impaired functioning of the gonad controlling glands (hypothalamus & pituitary).
Obesity.

  • Bleeding.
  • Pituitary disorders.
  • Exposure to radiation.
  • Sudden weight loss.
  • Genetic disorders: Kallmann syndrome.
  • History of diseases: TB, sarcoidosis, histiocytosis.
  • HIV/ AIDS.
  • Previous history of brain surgery, pituitary gland injury/ tumor.
  • Consumption opiates/ steroids.
  • Radiation treatment.

Symptoms of Hypogonadism:

Pre- Birth Growth:
In case of lack of testosterone supply to the male fetous during growth, the male feotus may develop:

  • Female genitals
  • Ambiguous genitals- neither male nor female genitals.
  • Underdeveloped male genitals

At Puberty:

Male hypogonadism obstructs the normal growth of the male reproductive system causing:

  • Ambiguous genitals.
  • Breast growth.
  • Immature voice.
  • Under development of reproductive organs.
  • Muscle loss.
  • Irregular body hair growth.
  • Excessive lemgth of the arms and legs as compared to the trunk of the body.

Adulthood:

  • Erectile dysfunction.
  • Decreased sex drive.
  • Problem of Infertility.
  • Breast tissue development (gynecomastia)
  • Weakness in muscles.
  • Loss of body hair.
  • Decrease in muscle mass.
  • Osteoporosis.
  • Lack of concentration.
  • Hot flashes.
  • Frequent fatigue.

Low Testosterone Diagnosis:

Hormones Tests:

  • Blood Test: Follicle stimulating hormone level, luteinizing hormone level.
  • Thyroid gland test.
  • Pitutary gland test.
  • Sperm Analysis.
  • Anaemia test.

Imagine tests:

  • MRI Scan.
  • CT scans.

Treatment:

Cause based treatment:

Low testosterone/ Erectile dysfunction:

  • Testosterone replacement therapy:
  • Gum tablet.
  • Skin patch/ gel.
  • Medicines like letrozole/ clomiphene.

To Trigger Puberty/ Sperm Production:

  • Injection to release gonadotropin hormone

Side- effects of Treatment:

Medication:

  • Sleep apnea.
  • Increased acne, blisters.
  • Irritable, itching skin under the testosterone.
  • Enlargement of prostate and other problems associated with it eg: urine trouble.

Replacement Therapy:

  • Increased risk of stroke/ heart attack.
  • Increased susceptibility to prostate cancer.
  • Risk of loss of fertility.

Prevention & Precaution is Better than Cure:

  • Regular check-up and tests.
  • Healthy balanced meals.
  • Avoid fatty foods.
  • High intake of fibrous foods.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient.