Male hypogonadism with a deficiency of testosterone is a relatively common disorder in clinical practice and has significant effects on the fertility, sexual function, and general health of affected men.
Hypogonadism can occur for a number of reasons, some relatively common and others rare. Certain men have hypogonadism from birth while others may develop this condition later in life. Types of hypogonadism include:
- Primary hypogonadism (testicular failure) – Low serum testosterone levels with gonadotropins (FSH, LH) above the normal range. Klinefelters, surgical removal, bilateral mumps related orchitis, toxic damage by alcohol, heavy metals or chemotherapy.
- Secondary (gonadotropin) hypogonadism – Caused by a pituitary failure or pituitary-hypothalamic injury from tumors, trauma, or radiation; characterized by low serum testosterone levels, but with gonadotropins in the normal or low range
Testicular atrophy may occur as the result of hernia repair, use of anabolic steroids, Klinefelter’s syndrome and normal aging, although relatively little is known about the mechanisms underlying germ cell loss in aging. Sterility from mumps is rare even when both testicles are involved. Some degree of testicular shrinkage may be detectable after the mumps infection; however, it does not cause sterility.
In adult males with low serum testosterone and elevated gonadotropin levels, primary testicular failure should be suspected, whereas low or normal gonadotropin and low testosterone levels suggest a hypothalamic or pituitary disorder.
In men with clinical symptoms of primary or secondary hypogonadism, the deficiency of testosterone can be treated effectively with currently available preparations. Clomid and Arimidex act by reducing the conversion of testosterone to estrogens. HCG is being used to mimic luetinizing hormone to increase testosterone production in athletes and those with testicular atrophy. It must be used carefully and cyclically to prevent side effects.
Signs, symptoms & indicators of Hypogonadism, Male
Individual weak muscles
Conditions that suggest Hypogonadism, Male
Having secondary/having primary hypogonadism
Counter Indicators
Absence of hypogonadism
Risk factors for Hypogonadism, Male
AIDS / Risk
Hypogonadism – decreased testosterone production – is a common problem in HIV-infected men.
Suspected hypogonadism
Hemochromatosis (Iron overload)
The disease may lead to the development of testicular atrophy, and occurs 5 times more frequently in men than women. Aside from diabetes mellitus, testicular atrophy is probably the most common endocrine manifestation of the disease; this is secondary to iron deposition in and dysfunction of the pituitary.
Hypogonadism, Male suggests the following may be present
AIDS / Risk
Hypogonadism – decreased testosterone production – is a common problem in HIV-infected men.
Recommendations for Hypogonadism, Male
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
Glossary
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Chemotherapy
A treatment of disease by any chemicals. Used most often to refer to the chemical treatments used to combat cancer cells.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Anabolic
Anabolic compounds: Allow the conversion of nutritive material into complex living matter in the constructive metabolism.
Steroid
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Klinefelter's Syndrome
Although still commonly used, the term "Klinefelter's syndrome" is slowly being replaced by the term XXY males to describe males having the extra X chromosome. It is the most common chromosomal abnormality in males, resulting in deficient testicular function and occurring in 1 out of 500 live births. Gynecomastia and various degrees of testosterone deficiency are usually noted.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Diabetes Mellitus
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.