Presentation
[…] testosterone production is normal because Leydig cells are not affected by ↑ temperature loss of negative feedback of testosterone results in ↑ LH FSH levels are variable based on presence of inhibin ↑ FSH if seminiferous tubule dysfunction is also present [medbullets.com]
الصفحة 69 - Men homozygous for an inactivating mutation of the follicle-stimulating hormone (FSH) receptor gene present variable suppression of spermatogenesis and fertility. Nat Genet 1997; 15:205-206. الصفحة 97 - Harman SM, Tsitouras PD. [books.google.com]
Symptoms and Signs Clinical presentation depends on whether, when, and how testosterone and sperm production are affected. (For presentation in adulthood, see Male Hypogonadism : Symptoms and Signs .) [merckmanuals.com]
Entire Body System
- Male Hypogonadism
Aim: The creation of new experimental model of primary male hypogonadism. Materials and methods: The study was conducted on the male Wistar rats, hypogonadism was modeled by temporary ligation of the distal part of the spermatic cord. [ingentaconnect.com]
NPs must select and follow the best guideline recommendations available to optimally treat male hypogonadism. [nursingcenter.com]
Overview: Male Hypogonadism 14. Primary Male Hypogonadism 15. Primary Male Hypogonadism: Klinefelter's Syndrome 16. Primary Male Hypogonadism: Testicular Trauma and Anorchia 17. Primary Male Hypogonadism: Infectious Agents 18. [sciencemedia.com]
Primary male hypogonadism results from an intrinsic abnormalit...... DRG Epidemiology's coverage of male hypogonadism comprises epidemiological... [decisionresourcesgroup.com]
- Fatigue
Symptoms include low testosterone, low energy, fatigue, and a lower sexual drive. [my.clevelandclinic.org]
Typical symptoms include a low sex drive, erectile dysfunction, infertility, fatigue, weight gain and enlarged breasts. Over time, hypogonadism can lead to bone loss, which increases the risk of fractures. [nyhq.org]
This is largely because the symptoms of hypogonadism are nearly identical to those experienced by men going through andropause (the male menopause): low libido, fatigue, depression, memory loss, difficulty concentrating, and irritability. [bodylogicmd.com]
These may include: Fatigue Decreased sex drive Difficulty concentrating Hot flashes When to see a doctor See a doctor if you have any symptoms of male hypogonadism. [mayoclinic.org]
[…] hypogonadism Prepubertal Delayed development of secondary sexual characteristics Small testes, genitalia Decrease in height Postpubertal Sexual difficulties Erectile dysfunction Infertility Decreased muscle and/or skeletal mass Decreased body hair Low energy, fatigue [arupconsult.com]
- Anemia
Other tests may measure thyroid hormones, sperm count and prolactin, a hormone released by the pituitary gland that stimulates breast development and milk production Tests also may be performed to test for anemia and possible genetic causes of symptoms [ucsfhealth.org]
You may need to have tests to check: Estrogen level (women) Follicle stimulating hormone ( FSH level ) and luteinizing hormone ( LH) level Testosterone level (men) Other measures of pituitary function Other tests may include: Blood tests for anemia and [medlineplus.gov]
By contrast, testosterone depletion is associated with: Loss of lean muscle mass Anemia Osteoporosis Insulin resistance Increased lipids (fat and/or cholesterol) in the blood Increased subcutaneous fat in the abdomen Testosterone Deficiency Testosterone [verywell.com]
Nonspecific signs and symptoms include depressed mood, sleep disturbance, mild anemia, sleepiness after a meal, reduced muscle mass, and increased body fat. [ahcmedia.com]
[…] afternoon.[ 4-6 ] Screening for hypogonadism in the general population is not indicated.[ 4 ] Case finding in selected circumstances is, however, acceptable, such as when testing for low testosterone is part of the workup for osteoporosis or unexplained anemia [bcmj.org]
- Epilepsy
[…] hypotonia,short stature, Cupid’s-bow mouth, DM, obesityLaurence-Moon Biedl retinitis pigmentosa, obesity, polydactyly, MRMultiple lentigines multiple lentigines, cardiac defect, hypertelorism, short stature, deafness, genital and uro. defectRud MR, epilepsy [slideshare.net]
[…] for ANOVA for age, analysis of covariance test (age adjusted) for continuous variables and χ 2 for categorical variables. b Self-reported health conditions including heart condition, high blood pressure, cancer ever, bronchitis, asthma, peptic ulcer, epilepsy [academic.oup.com]
Skin
- Sweating
[…] depressed mood decreased libido lethargy sleep disturbances decreased muscle mass and strength loss of body hair (pubic, axillary, facial) osteoporosis and decreased bone mineral density increased body fat breast discomfort and enlargement hot flashes sweating [medicalnewstoday.com]
[…] decreased sperm count soft, small testes mood changes increased body fat growth of breast tissue (gynaecomastia) thinning of the bones ( osteoporosis ) reduced muscle bulk and physical strength a wrinkled ‘parchment-like’ appearance of the skin increased sweating [yourhormones.info]
In addition to this, many of the hallmark symptoms of menopause begin to appear earlier than they should, including hot flashes and cold sweats. [hgh.tv]
Vogelxo $540 Axiron $690 Transdermal Patch Androderm 2 mg and 4 mg patches 2-6 mg (1-3 patches) daily 2 weeks after initiation; 3-12 hours after application Convenient Easy to use Physiologic pattern Application site irritation Adherence problems with sweating [ahcmedia.com]
Hot flushes, sweats 51 CLINICAL PRACTIC GUIDELINE 52. Group B: Symptoms and signs associated with androgen deficiency that are less specific than those in group A1. Decreased energy, motivation, initiative, aggressiveness, self confidence2. [slideshare.net]
Musculoskeletal
- Decreased Muscle Mass
Male hypogonadism symptoms during adulthood may include: Erectile dysfunction Infertility problems Decreased muscle mass Decreased body hair growth Loss of bone mass ( osteoporosis in men ) Gynecomastia Some men may develop symptoms similar to menopausal [health.in4mnation.com]
Finally, infertility, erectile dysfunction, decreased muscle mass and body hair, smaller testicles, gynecomastia, osteoporosis, mood changes, and decreased cognitive skills in adult men. [study.com]
[…] of bone mass) Gynecomastia Decreased muscle mass Reduced body hair and beard growth Difficulty concentrating Low sex drive Fatigue It is not uncommon for men to gain weight or become irritable due to low levels of testosterone. [performanceinsiders.com]
decreased muscle mass and strength loss of body hair (pubic, axillary, facial) osteoporosis and decreased bone mineral density increased body fat breast discomfort and enlargement hot flashes sweating poor concentration and decreased energy Causes Hypogonadism [medicalnewstoday.com]
Low serum testosterone causes significant clinical impact and can result in erectile dysfunction, low libido, decreased muscle mass and strength, increased body fat, decreased bone density, decreased vitality and depressed mood. [lipocine.com]
- Increased Muscle Mass
In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary characteristics, such as increased muscle mass, beard and pubic hair growth. [healthguidance.org]
He may not undergo the normal changes a boy has during puberty, such as a deepening voice, body and facial hair, and increased muscle mass. [dartmouth-hitchcock.org]
Treatment for boys In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis. [nchmd.org]
reduced muscle mass and strength (sarcopenia) Adipose tissue: increased fat mass Breast tissue: gynaecomastia Sexual and reproductive symptoms Decreased libido Erectile dysfunction (uncommon as a presenting feature of androgen deficiency, and then only [mja.com.au]
[…] also is associated with increased fat-free mass, decreased fat mass, and improved muscle strength. [ahcmedia.com]
Urogenital
- Sexual Dysfunction
Depending on when it begins, hypogonadism may affect the development of sex organs, interfere with puberty or cause infertility and sexual dysfunction. Children with hypogonadism do not progress through puberty. [chop.edu]
Dana Stoian, Ioana Mozos, Marius Craina, Corina Paul, Iulian Velea, Adalbert Schiller and Mihaela Craciunescu, Hypogonadism in Male Sexual Dysfunction, Sexual Dysfunction, 10.5772/intechopen.69107, (2017). [doi.org]
The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 234. [medlineplus.gov]
If it occurs after puberty, there may be infertility and sexual dysfunction. In adult men, symptoms begin within a few weeks of the onset of testosterone deficiency. [medicalnewstoday.com]
- Testicular Disease
Classified as primary (resulting from testicular disease), secondary (resulting from pituitary and/or hypothalamic disease), or combined primary/secondary. -- To view the remaining sections of this topic, please sign in or purchase a subscription -- Last [hopkinsguides.com]
disease. 2 - 4 Controversy has arisen over the role of testosterone treatment in older men with medical comorbidities who have low levels of circulating testosterone, in the absence of hypothalamic, pituitary or testicular disease. 5 There are gaps in [mja.com.au]
Hypogonadism can be classified into primary hypogonadism as a result of primary testicular disease or secondary hypogonadism as a result of a central defect of the hypothalamus or pituitary gland (Table 1 ). [link.springer.com]
Sperm are manufactured in cells known as seminiferous tubules, and these cells are more sensitive to the damage that results from most testicular diseases. [hgh.tv]
Results Categories of hypogonadism From 3369 participants in EMAS, 150 were excluded because of known pituitary, testicular, or adrenal diseases or current use of medications affecting pituitary/testicular functions (T, dehydroepiandrosterone, anti-androgens [academic.oup.com]
- Small Scrotum
Such patients have poor muscle development, a high-pitched voice, inadequate phallic and testicular growth, a small scrotum, sparse pubic and axillary hair, and absent body hair. [merckmanuals.com]
Workup
[…] growth and maturation Testicular tissue testing: If the testes are not palpable and if it is not certain whether any testicular tissue is present, administering human chorionic gonadotropin (hCG) and measuring testosterone response may be helpful See Workup [emedicine.medscape.com]
Available online at https://emedicine.medscape.com/article/922038-workup#c6. Accessed March 2018. (Updated 2018 March). Male Hypogonadism. ARUP Laboratories. Available online at https://arupconsult.com/content/hypogonadism-male. Accessed March 2018. [labtestsonline.it]
Primary Hypogonadism | Secondary Hypogonadism | Rx of Hypogonadism | 2011 Screening and Workup for Testosterone Deficiency Martin M. [enotes.tripod.com]
[…] in testosterone that occurs in the afternoon.[ 4-6 ] Screening for hypogonadism in the general population is not indicated.[ 4 ] Case finding in selected circumstances is, however, acceptable, such as when testing for low testosterone is part of the workup [bcmj.org]
This is also true in patients with an elevated prostate-specific antigen (PSA) >3 ng/mL, without further urologic workup. 7 Goals of Therapy Goals of treating hypogonadal patients are focused around improvement of those symptoms, many of which can be [uspharmacist.com]
X-Ray
- Delayed Bone Age
Delayed bone age (when maturity of the skeleton is behind for your age in years). [yourhormones.info]
Serum
- Testosterone Decreased
As testosterone decreases, some men may experience signs and symptoms similar to those of menopause in women. These may include hot flashes, decreased drive, irritability, depression and fatigue. [healthguidance.org]
As testosterone decreases, some men may experience symptoms similar to those of menopause in women. [mayoclinic.org]
A positive response is based on decreases in libido or strength of erections or any three nonspecific questions that include fatigability, decreases in muscle strength, mood changes, and loss of height. [care.diabetesjournals.org]
- Testosterone Increased
[…] in terms of bodyweight or metabolic syndrome. 43 The increase in testosterone level is proportional to the amount of weight lost: 10% weight loss increases testosterone by 2–3 nmol/L, whereas in morbidly obese men, profound weight loss after bariatric [mja.com.au]
Sex hormone- binding globulin (SHBG), the major serum carrier of testosterone, increased by 1.2%/yr, with the net effect that total serum testosterone declined more slowly (0.4%/yr) than the free or albumin-bound pools alone. 32 33. [slideshare.net]
Aromatase Conversion of Testosterone to Estrogen Some men are “ preferential aromatizer s”, meaning there is increased conversion of testosterone to estrogen via the aromatase pathway. [jeffreydachmd.com]
This results in increased conversion of testosterone to estradiol and enhanced testicular secretion of estradiol relative to testosterone. [enotes.tripod.com]
- Hematocrit Decreased
Check hematocrit; if it increases to >54%, stop therapy until hematocrit decreases into the normal range. Evaluate for OSA or other conditions associated with secondary erythrocytosis. Resume therapy at a lower dose. [clinicaladvisor.com]
Risks of Testosterone/Androgen Therapy Fluid retention GynecomastiaAcne/oily skin Increases hematocrit Decreases HDL cholesterol (cardiovascular risk?) Sleep apnea Prostate diseases: BPH, prostate carcinoma Aggressive behavior (?) [enotes.tripod.com]
Other Test Results
- Sperm Count Decreased
Symptoms include low sperm count, decreased libido, erectile dysfunction, fatigue, sleep disturbances and depression. In primary hypogonadism, the testes fail to make testosterone because of infection or injury to the testes. [froedtert.com]
Treatment
Updated evidence-based prescribing information reflects the latest national clinical practice guidelines and evidence-based treatment guidelines, including the latest clinical treatment guidelines for diabetes. NEW! [books.google.com]
Hypogonadism Treatment For men with primary hypogonadism, treatment typically involves lifelong testosterone replacement therapy. [froedtert.com]
Treatment for female hypogonadism If you’re female, your treatment will involve increasing your amount of female sex hormones. Your first line of treatment will probably be estrogen therapy if you’ve had a hysterectomy. [healthline.com]
METHODS: We performed a prospective, randomized, trial assigning 53 hypogonadal men to the following treatment groups: mesterolone 100 mg p.o. daily, testosterone undecanoate 160 mg p.o. daily, testosterone enanthate 250 mg i.m. every 21 days, or a single [ncbi.nlm.nih.gov]
Male Hypogonadism Treatment Treatment for male hypogonadism varies depending on the stage of development. [health.in4mnation.com]
Etiology
[…] testosterone – secondary or tertiary hypogonadism Prolactin Consider prolactin measurement in secondary hypogonadism Elevated prolactin should prompt evaluation of pituitary gland Associated testing – Endocrine Society recommends investigating causes/etiology [arupconsult.com]
[…] levels are variable based on presence of inhibin ↑ FSH if seminiferous tubule dysfunction is also present inhibin normally released by Sertoli cells to inhibit FSH if damaged that feedback is lost normal FSH if dysfunction is limited to Leydig cells etiologies [medbullets.com]
[…] body system manifestations due to the underlying etiology. [icd10data.com]
Prior to initiating therapy with AndroGel 1.62% Determine the specific etiology: If hypogonadism is suspected, identify the underlying medical condition that is causing it 1 Confirm the diagnosis: Investigate a diagnosis of hypogonadism by performing [androgelpro.com]
Epidemiology
DRG Epidemiology's coverage of male hypogonadism comprises epidemiological... [decisionresourcesgroup.com]
This CME supplement discusses the definition, epidemiology and key signs and symptoms of late-onset hypogonadism, the role of lab measurements, factors to consider in selecting patients for testosterone replacement therapy, and how to identify the best [mdedge.com]
Epidemiology of Adult and Late-Onset Hypogonadism 25. Pathophyisology of Adult and Late-Onset Hypogonadism: Testosterone 26. Pathophyisology of Adult and Late-Onset Hypogonadism: Hypothalamus, Pituitary, Testes 27. [sciencemedia.com]
Links: epidemiology aetiology hypothalamic - pituitary - gonadal (HPG) axis in testosterone deficiency (TD) clinical features screening and assessment for testosterone defiency (TD) investigation in testosterone deficiency treatment testosterone androgen [gpnotebook.co.uk]
Lee 1Arthritis Research Campaign Epidemiology Unit (A.T., T.W.O., D.M.L., A.J.S., J.D.F.), The University of Manchester, Manchester M15 6PB, United Kingdom Search for other works by this author on: Alan J. [academic.oup.com]
Pathophysiology
Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann’s syndrome): pathophysiological and genetic considerations. Endocr Rev 19: 521, 1998. [link.springer.com]
Published on Apr 27, 2012 Male Hypogonadism :etiology, pathophysiology, prevalence, diagnosis by R.Tavakkolnia MD, urologist 1. HYPOGONADISM:ETIOLOGYEPIDEMIOLOGYPREVALENCE Rahim TavakkolniaDIAGNOSIS urologist 1 2. [slideshare.net]
Prader-Willi syndrome Neoplastic disorder Craniopharyngioma Germ cell tumors Histocytosis X Inflammatory cause Granulomatosis with polyangiitis Sarcoidosis Infection – Mycobacterium tuberculosis Age-related hypogonadism – pathology in testes and hypothalamus Pathophysiology [arupconsult.com]
This review will discuss the definitions, pathophysiology, causes, clinical manifestations, appropriate diagnostic testing procedures, and the role of testosterone supplementation with currently available formulations, with special attention to efficacy [ahcmedia.com]
Prevention
Prevention of Hypogonadism In many cases, such as with tumors, there is no way to prevent Hypogonadism. It can only be treated as symptoms arise. [hgh.tv]
What Should I Do to Prevent Testicular Cancer? To prevent testicular cancer, all men should be familiar with the size and feel of their testicles, so they can detect any changes. [webmd.com]
Testosterone replacement therapy can help restore muscle strength, and prevent bone loss. Replacement also increases energy, sexual function and sex drive, and a sense of well-being. [health.in4mnation.com]
The earlier it’s detected, the sooner he can prevent long-term effects and treat current symptoms. [thebump.com]
Coping and Support Prevent osteoporosis. If hypogonadism occurs during adulthood, make lifestyle and dietary changes to prevent osteoporosis. [diabetesalaska.com]