Hypogonadism

Hypogonadism is a medical term for a defect of the reproductive systemwhich results in lack of function of the gonads(ovariesor testes). The gonads have two functions: to produce hormones(testosterone, estradiol, antimullerian hormone, progesterone, inhibin B), activinand to produce gametes(eggsor sperm). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature menopause) in adults. Defective egg or sperm development results in infertility.

The term hypogonadism is usually applied to permanent rather than transient or reversible defects, and usually implies deficiency of reproductive hormones, with or without fertilitydefects. The term is less commonly used for infertility without hormone deficiency.

Classification

There are many possible types of hypogonadism and several ways to categorize them.

by Congenital vs. acquired

• An example of congenitalhypogonadism (present at birth) is Turner syndrome.
• An example of acquiredhypogonadism (develops in childhood or adult life) is castration.

by Hormones vs. fertility

Hypogonadism can involve just hormoneproduction or just fertility, but most commonly involves both.

• Examples of hypogonadism that affect hormone production more than fertility are hypopituitarismand Kallmann syndrome; in both cases fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement.
• Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndromeand Kartagener syndrome.

by Affected system

Hypogonadism is also categorized by endocrinologists by the level of the reproductive system which is defective.

• Hypogonadism resulting from defects of the gonadsis traditionally referred to as primary hypogonadism. Examples include Klinefelter syndromeand Turner syndrome.

• Hypogonadism resulting from hypothalamicor pituitarydefects are termed secondary hypogonadism or central hypogonadism (referring to the central nervous system).
  • Examples of Hypothalamicdefects include Kallmann syndrome
  • Examples of Pituitarydefects include hypopituitarism

• An example of a hypogonadism resulting from hormone response is androgen insensitivity syndrome

Diagnosis

Physicians measure gonadotropins(LHand FSH) to distinguish primary from secondary hypogonadism. In primary hypogonadism the LH and/or FSH are usually elevated, while in secondary hypogonadism both are normal or low.

Hypogonadism is often discovered during evaluation of delayed puberty, but ordinary delay which eventually results in normal pubertaldevelopment and reproductive function is termed constitutional delay.

Treatment

Hypogonadism is most often treated by replacement of the appropriate hormones. For men this is testosterone. For women estradioland progesteroneare replaced. Some types of fertility defects can be treated; some cannot.

External links

• NIH
• eMedicinefr:Hypogonadisme

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Hypogonadism Wikipedia article Hypogonadism.