April
28
23:00
Endocrine diseases

Hypogonadism

Hypogonadism

hypogonadism hypogonadism (gonadal failure, gipogenitalizme) - endocrine disease, due to decreased levels of androgens in the body and is characterized by hypoplasia of the external and internal genitalia, as well as clearly expressed secondary sexual characteristics.Hypogonadism distinguish between primary and secondary

Causes

primary hypogonadism is caused by direct lesion of gonads, which may be due to genetic factor, after trauma or infectious - inflammatory process occur during embryogenesis, result from hormone - inactive tumorsgonads or castration.

development of secondary hypogonadism is caused by weak stimulation of gonads pituitary gonadotropin-releasing hormone (from - for their lack of fusion) as a result of the destruction of the adenohypophysis infectious - inflammatory process, tumor or traumatic injury.The secondary form of hypogonadism may occur when pituitary dwarfism, hypophyseal syndrome, acromegaly etc.

In women the most common cause of decreased synthesis of

gonadotropins has developed a pituitary necrosis after massive blood loss during childbirth.In some cases, patients may experience a congenital disorder of production gonadotropins (or hypothalamic neurohormones) or these hormones can be produced in the form of inactive forms

Symptoms

Clinical manifestations depend on the degree of androgen deficiency and the patient's age.There are dopubertatnogo and postpubertatnom forms of the disease.If testicular damage occurred before puberty, there is underdevelopment of the shoulder girdle and chest, limb lengthening, disproportionate growth, developing the typical eunuchoid syndrome.Also, there is the weak development of the skeletal muscles and the distribution of the female type of subcutaneous fat.Pale skin, presence of gynecomastia.Secondary sexual characteristics developed quite weak: no body hair on the body and face, hypoplasia of the larynx, the pubic body hair on the female type, high-pitched voice.Sexual organs are underdeveloped: hypoplastic testicles, penis small size;scrotum is formed, however, depigmented, without folding;the prostate gland is underdeveloped (may not be palpable palpation).

In secondary hypogonadism, in addition to symptoms of androgen deficiency, obesity is often observed, as well as other symptoms of hypofunction of endocrine glands (the adrenal cortex, thyroid gland).The potency and sex drive completely absent.

If testicular damage occurred after puberty (the formation of musculoskeletal tissues and sexual development has already ended), symptoms of hypogonadism less pronounced.Reduced body hair body and face, the skin becomes thinner and loses its elasticity, develops obesity of female type, reduced testes, violated sexual function, there are vegetatively - vascular disorder develops infertility

Diagnostics

diagnosis of hypogonadismadjusted based on the signs that indicate the underdevelopment of internal and external genitalia, absent or not clearly expressed secondary sexual characteristics, the results of X-ray and cytogenetic studies.Primary hypogonadism should be differentiated from secondary hypogonadism, based on the contents of serum gonadotropins

Treatment

Treatment of primary hypogonadism is the use of sex hormones replacement therapy.Treatment of secondary hypogonadism is carried drugs gonadotropins (sometimes combining them with sex hormones), and do drugs and their dosage are chosen strictly individually.Because of adequate systemic treatment develop secondary sexual characteristics in men may be a partial recovery of potency (sometimes recovered spermatogenesis), women appear menstruation.

Surgical treatment of hypogonadism includes the transplantation of the ovary or testis, phalloplasty (plastic correction underdeveloped penis), testicular cryptorchidism relegation.Perhaps the implantation of synthetic eggs (if nespustivsheesya egg is missing in the abdominal cavity).

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