- Published on
Pathology - Male Hypogonadism
The disorder is caused by insufficient testosterone release from the testes. Congenital causes of male hypogonadism include the chromosomal abnormalities Klinefelter’s syndrome (47, XXY plus variants) and mutations such as those in Kallmann syndrome that result in the loss of GnRH secreting neurons. The patient in this example has a past history of normal fertility, indicating he has an acquired etiology of hypogonadism.
Inadequate testosterone levels account for loss of libido, erectile dysfunction, decreased muscle mass, weariness, and depression. Severe chronic cases may also result in loss of facial, body, and pubic hair. The condition can be classified as hypogonadotropic (normal or low LH, as in this example) or hypergonadotropic (high LH due to primary testicular failure and loss of negative feedback on LH secretion). This patient has no clear identifiable cause of hypogonadism such as pituitary disease, hypothyroidism, granulomatous disease, or adverse drug reaction but rather has a functional reason related to obesity, aging, and chronic ill health. Testosterone levels normally fall 1–2% every year at the age of 40 years and the aromatase activity of adipose tissue converts testosterone to estrogen. Testosterone replacement usually restores virility, but its usage must be balanced against the increased risk of cardiovascular events, and it should not be used while active prostate cancer is present.
The disorder is caused by insufficient testosterone release from the testes. Congenital causes of male hypogonadism include the chromosomal abnormalities Klinefelter’s syndrome (47, XXY plus variants) and mutations such as those in Kallmann syndrome that result in the loss of GnRH secreting neurons. The patient in this example has a past history of normal fertility, indicating he has an acquired etiology of hypogonadism.
Inadequate testosterone levels account for loss of libido, erectile dysfunction, decreased muscle mass, weariness, and depression. Severe chronic cases may also result in loss of facial, body, and pubic hair. The condition can be classified as hypogonadotropic (normal or low LH, as in this example) or hypergonadotropic (high LH due to primary testicular failure and loss of negative feedback on LH secretion). This patient has no clear identifiable cause of hypogonadism such as pituitary disease, hypothyroidism, granulomatous disease, or adverse drug reaction but rather has a functional reason related to obesity, aging, and chronic ill health. Testosterone levels normally fall 1–2% every year at the age of 40 years and the aromatase activity of adipose tissue converts testosterone to estrogen. Testosterone replacement usually restores virility, but its usage must be balanced against the increased risk of cardiovascular events, and it should not be used while active prostate cancer is present.
0 Comments
