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Hypogonadism

Hypogonadism is a condition in which one or both the testis are smaller in size Congenital or Acquired.

Puberty

Male hypogonadism may delay puberty or cause incomplete or lack of normal development. It can cause:

  • Decreased development of muscle mass.
  • Lack of deepening of the voice.
  • Impaired growth of body hair.
  • Impaired growth of the penis and testicles.
  • Excessive growth of the arms and legs in relation to the trunk of the body.
  • Development of breast tissue (gynecomastia).

Adulthood

In adult males, hypogonadism may alter certain masculine physical characteristics and impair normal reproductive function. Signs and symptoms may include:

  • Erectile dysfunction
  • Infertility
  • Decrease in beard and body hair growth
  • Decrease in muscle mass
  • Development of breast tissue (gynecomastia)
  • Loss of bone mass (osteoporosis)

Hypogonadism can also cause mental and emotional changes. As testosterone decreases, some men may experience symptoms similar to those of menopause in women. These may include:

  • Fatigue
  • Decreased sex drive
  • Difficulty concentrating
  • Hot flashes

Causes

Primary Hypogonadism

Common causes of primary hypogonadism include:

  • Klinefelter syndrome - congenital abnormality.
  • Undescended testicles.
  • Mumps orchitis.
  • Hemochromatosis.
  • Injury to the testicles.
  • Cancer treatment.

The testicles are normal but function improperly due to a problem with the pituitary or hypothalamus.

  • Kallmann syndrome.
  • Pituitary disorders.
  • Inflammatory disease. Such as sarcoidosis, histiocytosis and tuberculosis, involve the hypothalamus and pituitary gland
  • HIV/AIDS. HIV/AIDS can cause low levels of testosterone
  • Medications.
  • Obesity. Being significantly overweight at any age may be linked to hypogonadism.
  • Normal aging.
  • Concurrent illness.

Diagnosis

Physical examination of secondary sexual characteristics like pubic hair, muscle mass and size of your testes, is consistent with your age

Blood tests – Testosterone, Free Testosterone (to be done before 10am)

If tests confirm you have low testosterone, further testing can determine if a testicular disorder or a pituitary abnormality is the cause. Based on specific signs and symptoms, additional studies can pinpoint the cause. These studies may include:

  • Hormone testing
  • Semen analysis
  • Pituitary imaging
  • Genetic studies
  • Testicular biopsy

Testosterone testing also plays an important role in managing hypogonadism. This helps your doctor determine the right dosage of medication, both initially and over time.

Treatment for adults

Treatment for male hypogonadism depends on the cause and whether you're concerned about fertility.

  • Hormone replacement. Testosterone replacement therapy, or TRT, TRT can restore muscle strength and prevent bone loss. In addition, men receiving TRT may experience an increase in energy, sex drive, erectile function and sense of well-being.
  • Assisted reproduction. Although there's often no effective treatment to restore fertility in a man with primary hypogonadism, assisted reproductive technology may be helpful.

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