Hypogonadotropic hypogonadism: symptoms, treatment

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2018-04-29 23:00:39

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As a rule, hypogonadotropic hypogonadism associated with underdeveloped sexual organs and secondary sexual characteristics. Fat and protein metabolism in the pathology also disturbed, which causes obesity, cachexia, disorders in the skeletal system and affect the heart.

Hypogonadotropic hypogonadism

What doctors to contact?

It Should be noted that different male and female hypogonadotropic hypogonadism.

Diagnosis and treatment of diseases is conducted by doctors-endocrinologists, gynecologists and obstetricians-endocrinologie if the patient is a woman, and andrology, if the patient is a man.

The mainstay of treatment is hormonal therapy. If necessary shown surgery, plastic surgery.

Classified As a disease?

Hypogonadism may be primary and secondary. The primary form is triggered by disruption in the functionality of the testicular tissue due to a defect in the testes. Abnormalities on the chromosomal level that can cause aplasia or hypoplasia testicular tissue, which is manifested in the lack of secret of androgens or the lack of development for the full formation of sexual organs and secondary sexual characteristics.

Hypogonadotropic hypogonadism in boys is expressed in the mental infantilism.

The Secondary form caused by the violation of the structure of the pituitary gland, decreased gonadotropic functions of or damage to centers of the hypothalamus that influence the pituitary gland and regulates its activity. The disease is expressed in mental disorders.

Both primary and secondary shape can be congenital or acquired. Pathology can contribute to male infertility in 40-60 % of cases.

Hypogonadotropic hypogonadism in boys

The causes of the disease in men

Low amount of androgen can be caused by a reduction in the amount produced of hormones or abnormal condition of eggs, a dysfunction of the hypothalamus and pituitary gland.

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The etiology of the primary manifestations of the disease could be considered:

  • Congenital underdevelopment sexual glands, which occurs when genetic defects of character,
  • Aplasia of the testes.

Predisposing factors include:

  • Violation of the dropping of the testicles;
  • Exposure to toxic substances;
  • Chemotherapy;
  • The effects of organic solvents, nitrofurans, pesticides, alcohol, tetracycline, preparations on a hormonal basis, in high doses, etc.;
  • Diseases of infectious nature (mumps, measles, orchitis, vesiculitis);
  • The presence of radiation disease;
  • Acquired pathology of the testicles;
  • Twisting of the spermatic cord;
  • Twisting of the testicles;
  • Atrophic process after the surgery;
  • Excision hernia;
  • Surgery in the scrotum.

In primary hypogonadism there is a decline in the level of androgens in the blood. Developing compensatory reaction of the adrenal glands, increases production of gonadotropins.

The secondary form the result of violations of the hypothalamus and pituitary (inflammatory processes, tumors, disruption in the blood vessels, pathology of fetal development).

To contribute to the development of secondary hypogonadism can:

  • Pituitary adenoma producing growth hormone
  • Adrenocorticotropic hormone (Cushing's disease);
  • A prolactinoma;
  • Dysfunction of the pituitary or hypothalamus after surgery;
  • The aging process, which causes the decrease in the testosterone in the blood.

When the secondary form, there is a decrease of gonadotropins, leading to decrease the production of androgens by the testes.

One form of disease affecting men is the decrease in sperm production at normal rate of testosterone. Very rarely, a decrease in testosterone levels at a normal level of sperm.

Symptoms of the disease in men

Hypogonadotropic hypogonadism in men has its own clinical manifestations. They are caused by the patient's age and the level of insufficiency of androgens.

Hypogonadotropic hypogonadism in men

If the affected testes of a boy before puberty, is formed by a typical evnuhoidizm. The skeleton thus becomes disproportionately large. This is due to delayed ossification in the growth zone. Shoulder area and chest is also lagging in development, the limbs become long, skeletal musculature is poorly developed.

May be a obesity of the female type, gynecomastia, gipogenitalizme, which is manifested in the small size of the penis, the absence of folds in the scrotum, hypoplasia of the testes, immaturity of the prostate, absence of hair in the pubic area, underdevelopment of the larynx, a high tone of voice.

When secondary manifestation of the disease is often marked by the great weight of the patient increased function of the adrenal cortex, disruption of the thyroid gland.

If the function of the testes is reduced after puberty, the symptoms of this pathology as hypogonadotropic hypogonadism, can be traced to weaker.

Note the following effects:

  • Reduction of the testes;
  • Small hair on the face and body;
  • Loss of elasticity of the skin and its thinning;
  • Decreased sexualfunctions;
  • Autonomic disorders.

Reducing the size of the testicles is always associated with reduced production of sperm. It causes infertility, there is regression of secondary sexual characteristics, marked muscular weakness, asthenia.

Diagnosis of hypogonadism in men

Diagnosis is done through anthropometry, examination and palpation of the genitals, the evaluation of clinical symptoms the extent of puberty.

X-ray examination will help to assess bone age. To determine the saturation of the minerals used bone densitometry. During an x-ray of the Turkish saddle is determined by its size and the presence of tumors.

Evaluation of bone age allows the timing of ossification of the joints of the hand and wrist to determine when they began puberty. This should take into account the possibility of earlier (for patients born in the South) and later (for patients born in the North) ossification, as well as the fact that the violation of osteogenesis can be caused by other factors.

Research in the field of laboratory sperm allows to talk about such as azo - or oligospermia.

Refers to the content of these hormones:

  • Sexual gonadotropins;
  • Total and free testosterone;
  • Luteinizing hormone;
  • Leaks;
  • Antiurease hormone;
  • Prolactin;
  • Estradiol.

The primary form of the disease index of gonadotropins in the blood increased, and the secondary is lowered. Sometimes their level within the rules.

The Determination of estradiol in serum at clinically expressed need of feminization and the secondary manifestation of the disease, in the case of tumors in the testicles that produce estrogen, or tumors of the adrenal glands.

The Index of the content of ketosteroids in the urine may be normal or reduced. If you suspect the presence of Klinefelter's syndrome are shown to analyze the chromosomes.

The testis is not able to provide information for correct diagnosis.

Treatment

Treatment of hypogonadotropic hypogonadism is aimed at elimination of the main causes of the pathology. The goal of therapy lies in prevention activities that contribute to the normalization of sexual development, the subsequent recovery testicular tissue testicular and elimination of infertility. Therapy is conducted under the supervision of a urologist and endocrinologist.

It eliminates hypogonadotropic hypogonadism in men? Treatment depends on several factors:

  • Clinical form of pathology;
  • The severity of the dysfunction of hypothalamus, pituitary and reproductive system;
  • The presence of existing pathologies in parallel;
  • Time of occurrence of the disease;
  • The age of the patient.

Hypogonadotropic hypogonadism in men treatment

Treatment of adult cases is the correction of androgen levels and the elimination of sexual dysfunction. Infertility, which arose in the congenital form of hypogonadism, treatment can not be.

In the case of primary congenital shape anomalies or acquired disease with the preservation of endocrinocytes in the testicles used performance-enhancing drugs. Boys are treated with non-hormonal means, and adult patients - drugs for hormonal (androgens and gonadotropins in small doses).

In the absence of reserve function of the testes shows substitutive therapy by means of androgens and testosterone. Hormonal therapy is carried out throughout life.

The secondary form of the disease in children and adults it is necessary to use hormone therapy with gonadotropins. If necessary, they are combined with sex hormones.

Also shown restorative treatment and exercise.

Surgery for the disease is transplantation of the ovary with cryptorchidism, with underdevelopment of the penis is used in plastic surgery. Cosmetics have resorted to the implantation of the egg on a synthetic basis (in the absence of naoumenko eggs in the abdominal cavity).

Surgery is used when using microsurgical techniques along with monitoring of the immune system, hormone levels, and of the implanted organ.

In the process of systematically therapy decreases androgen insufficiency, resumed the development of secondary sexual characteristics, is partially restored potency, decrease symptoms of osteoporosis and the backlog of bone age.

How is the disease in women

Hypogonadotropic hypogonadism in women is characterized by underdevelopment and high function of sexual glands ovaries. The primary form is due to congenital underdevelopment of the ovaries or damage in the neonatal period.

There is low production of sex hormones, which provokes an increase of gonadotropins that stimulate the ovaries.

The analysis notes the high rate of hormones that stimulate follicles and lutein and low levels of estrogen. A reduced measure of estrogen causes atrophy or underdevelopment of the female genital organs, mammary glands, absence of menstruation.

If ovarian function was broken before puberty, there is a lack of secondary sexual characteristics.

Hypogonadotropic hypogonadism in women

Hypogonadotropic hypogonadism in women in the primary view is marked with the followingStates:

  • Congenital violation at the genetic level;
  • Congenital ovarian hypoplasia;
  • Infectious processes (syphilis, tuberculosis, mumps, radiation, surgical removal of the ovaries);
  • The defeat of the autoimmune nature;
  • The syndrome of testicular feminization;
  • Polycystic ovaries.

Secondary hypogonadotropic hypogonadism in women occurs with the pathology of the pituitary and hypothalamus. It is distinguished by a low content or complete cessation of the production of gonadotropins that regulate ovarian function. This process is triggered by inflammation in the area of the brain. Such diseases have a deleterious effect and are accompanied by reducing the impact of gonadotropins on the ovaries.

How are such diseases as hypogonadotropic hypogonadism in women and pregnancy? Adverse intrauterine development of the fetus can also affect the occurrence of disease.

Hypogonadotropic hypogonadism in women and pregnancy

Symptoms in women

Notable symptoms in their child - bearing period is the menstrual or lack thereof.

Low levels of female hormones leads to underdevelopment of genitals, mammary glands, disruption of the deposition of fat and lean owolosenia.

If the disease is congenital in nature, secondary sexual characteristics do not appear. Women have reported the presence of a narrow flat pelvis and buttocks.

If the disease occurred before puberty, sex characteristics that appear, remain saved, but the month ends, the tissue of the genitals atrophy.

Diagnostics

When hypogonadism with marked reduction of estrogen and increase of gonadotropins. Through ultrasound revealed small uterus, diagnosed osteoporos and delay the formation of the skeleton.

Treatment of disease in women

It eliminates hypogonadotropic hypogonadism in women? Treatment involves replacement therapy. Women assigned to medications and sex hormones (estrogens).

In the case of menstruation prescribe oral contraceptives containing estrogens and progestins, and drugs "Triziston", "Triquilar".

Means "Klimen", "Trisequens", "Klimonorm" prescribed to the patients after 40 years.

Treatment hormonal products are contraindicated under the following conditions:

  • Cancer tumor in the breast and genitals;
  • Diseases of the heart and blood vessels;
  • Pathology of the kidneys and liver;
  • Venous thrombosis.

Hypogonadotropic hypogonadism in women treatment

Prevention

A disease Such as hypogonadotropic hypogonadism, has a favorable prognosis. Prevention is health education and prenatal care, as well as events on health.


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Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."

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