Hypogonadism
Hypogonadism is a syndrome characterized by hypofunction of the gonads (gonads). Pathological changes are caused by a decrease in the level of production of sex hormones.
Characteristic signs of hypogonadism are the underdevelopment of the organs of the reproductive system. These abnormalities often accompany diseases of the cardiovascular system and pathologies of bone tissue. Usually, the disease disrupts the metabolism of lipids and proteins, which provokes emaciation or obesity.
Hypogonadism in children causes the child to lag behind in physical and sexual development. In some cases, the clinical picture of the disease "blooms" in teenagers during the period when active puberty should normally begin.
Male hypogonadism
Hypogonadism in men can be primary or secondary. If the patient is diagnosed with reproductive function problems, then in about half of the cases hypogonadism is detected.
The development of primary hypogonadism is often caused by dysfunction of the testicles against the background of pathological changes at the tissue level. Hypoplasia (underdevelopment) or aplasia is a consequence of chromosomal disorders. The pathology is manifested by a sharp deficiency or complete absence of testosterone production, as a result of which the formation of primary and secondary sexual characteristics is disturbed.
Pathologies accompanying congenital primary hypogonadism:
- testicular hypoplasia;
- non-descension of the testicles into the scrotum;
- false hermaphroditism (insensitivity of tissues to male sex hormones);
- some genetic diseases.
Pathologies causing acquired secondary hypogonadism:
- neoplastic neoplasms of the testicles;
- traumatic damage to the testicles (including during surgical interventions);
- Klinefelter's false syndrome.
Secondary hypogonadism is associated with pathological changes in the structure of the pituitary gland or parts of the hypothalamus responsible for the regulation of pituitary functions. It can also be congenital or acquired.
Forms of hypogonadism:
- embryonic;
- prepubescent (from the moment of birth to the age of 12);
- postpuberty.
Please note: With hypogonadism in men, it is possible to reduce the production of sperm against the background of a high level of testosterone. In rare cases, a reduced level of this androgen is noted with a normal level of seminal fluid production.
Hypogonadism in women
The development of the syndrome in women is caused by a decrease in the functional activity of the ovaries.
Primary hypogonadism in women is caused by early structural disorders of the reproductive organs - ovarian hypoplasia in the embryonic period or tissue damage shortly after the birth of a girl. The extremely low content of estrogens in the blood causes underdevelopment of the organs of the reproductive system and mammary glands, and also leads to primary amenorrhea. With significant dysfunction of the ovaries in the pre-pubertal period, secondary sexual characteristics almost do not develop.
Causes of the primary form of the syndrome:
- congenital hypoplasia;
- infections;
- polycystic ovary;
- surgical removal of ovaries;
- radiation damage;
- genetically determined disorders;
- autoimmune processes.
The secondary type of the syndrome is caused by disorders of the hypothalamic-pituitary system. As a result, the formation and release of gonadotropins (hormones responsible for regulating the functions of the ovaries) ceases, or their sharp deficiency is observed.
Possible causes of secondary female hypogonadism:
- brain tumors affecting the pituitary gland and/or hypothalamus;
- infectious and inflammatory diseases of the brain (arachnoiditis, meningitis, encephalitis.
The development of the syndrome during or after puberty leads to atrophy of the tissues of the organs of the reproductive system and cessation of menstruation. The syndrome is a common reason why a woman cannot get pregnant.
Treatment of hypogonadism
The basic method used in the treatment of the syndrome is replacement therapy. It involves the appointment of hormonal drugs to the patient.
Conservative treatment of hypogonadism in boys and men is within the competence of andrologists, in women pathology is dealt with by gynecologists and endocrinologists.
Therapeutic tactics for hypogonadism in each specific case are purely individual. The doctor must take into account the form of pathology, the age of the patient, the presence of concomitant diseases. The main task of therapy is the prevention of delayed puberty, as well as the prevention of infertility and malignant degeneration of the testicles.
According to the indications, surgical intervention is performed. Operative treatment of the consequences of hypogonadism may involve testicle transplantation, testicular prosthetics (in order to eliminate a cosmetic defect), as well as plastic surgery of the penis if it is underdeveloped.
Treatment of the primary type of syndrome in women involves the appointment of ethinyl estradiol, as well as contraceptive pills containing progestogens and estrogens.
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