Male Hypogonadism – What it is, Causes, Symptoms and Treatments that many are unaware of. Furthermore, Male Hypogonadism is a condition in which the body does not produce enough testosterone – the hormone that plays a key role in male growth and development during puberty – or has a decreased ability to produce sperm, or both.
This condition can be due to a testicular disorder or the result of a disease process involving the hypothalamus and pituitary gland.
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Male hypogonadism can have adverse effects on many organ functions as well as negatively influence a male’s quality of life. The signs and symptoms of Male Hypogonadism depend on the age of onset, the severity of the testosterone deficiency and whether or not there is a decrease in the main functions of the testes.
Because testosterone plays such an important role in a male’s general and reproductive health, any symptoms suggestive of Male Hypogonadism should be discussed with and evaluated by an attending physician.
You can be born with male hypogonadism , or it can develop later in life, often from an injury or infection. The effects and what you can do about them depend on the cause and at what point in your life Male Hypogonadism occurs . Some types of Male Hypogonadism can be treated with testosterone replacement therapy.
Causes of Male Hypogonadism: In Primary Male Hypogonadism , the testes do not respond to hormonal stimulation. This may be due to a congenital disorder, such as Klinefelter syndrome, or acquired as a result of treatment by radiation, chemotherapy, mumps, tumors, or trauma to the testicles.
In secondary male hypogonadism , a disease state interferes with either the hypothalamus or pituitary gland, major glands that release hormones to stimulate the testes to produce testosterone.
Situations that can cause secondary Male Hypogonadism include:
- systemic disease
- medication side effects
- liver cirrhosis
- Toxins (alcohol and heavy metals)
- Obesity morbidity.
Finally, the term andropause is sometimes used to describe decreased testosterone due to the normal aging process. Testosterone levels in men increase until the age of 17 years. Then, starting at approximately age 40, testosterone levels begin to decline by 1.2-2% per year.
Symptoms of Male Hypogonadism: Because testosterone affects many tissues, a lack of testosterone can cause many different symptoms.
Symptoms depend on age of onset, amount of testosterone deficiency, and how long the loss has been occurring. Adolescents and young adults who have not yet completed puberty look younger than their chronological age.
They may also exhibit small genitalia, lack of facial hair, failure of the voice to deepen and have difficulty gaining muscle mass despite exercise.
Symptoms of Puberty Onset Male Hypogonadism :
- impaired sexual development
- testicular size decreased
- breast enlargement (gynecomastia).
Symptoms of Adult Onset Male Hypogonadism :
- erectile dysfunction
- Low sperm count
- depressed mood
- decreased libido
- sleep disorders
- Decreased muscle mass and strength
- Loss of body hair (pubic, axillary, facial)
- Osteoporosis and decreased bone mineral density
- Increase in body fat
- discomfort and breast enlargement
- hot flashes
- Lack of concentration and decreased energy.
Risk factors for developing Male Hypogonadism include type 2 diabetes, obesity, kidney failure, HIV, hypertension, chronic obstructive pulmonary disease (COPD) and taking glucocorticoids (esters), opioid or antipsychotic medication therapy.
Diagnosis of Male Hypogonadism: Your doctor will perform a physical exam during which he or she will note whether your sexual development, such as pubic hair, muscle mass, and the size of your testicles, is consistent with your age. Your doctor may test your blood testosterone level if you have any of the signs or symptoms of Male Hypogonadism .
Early detection in boys can help prevent late puberty problems. Early diagnosis and treatment in men offers better protection against osteoporosis and other related conditions.
Doctors base a diagnosis of Male Hypogonadism on symptoms and results of blood tests that measure testosterone levels . As testosterone levels vary and are usually highest in the morning, the blood test is usually done earlier in the day, before 10 am.
If tests confirm that you have low testosterone , additional tests can determine whether a testicular disorder or pituitary abnormality is the cause. Based on specific signs and symptoms, additional studies can identify the cause of Male Hypogonadism . These studies may include:
- hormone test
- semen analysis
- pituitary image
- genetic studies
- testicular biopsy
Testosterone testing also plays an important role in the management of Male Hypogonadism . This helps your doctor determine the right dose of medication, both initially and over time.
Treatments for Male Hypogonadism: Treatment for Male Hypogonadism depends on the cause and whether you are concerned about fertility.
Hormone Replacement: For Male Hypogonadism caused by testicular failure , doctors use male hormone replacement therapy ( testosterone replacement therapy , or TRT). TRT can restore muscle strength and prevent bone loss.
Additionally, men given TRT may experience an increase in energy, sex drive, erectile function and a sense of well-being.
If a pituitary problem is the cause of Male Hypogonadism , pituitary hormones can stimulate sperm production and restore fertility. Testosterone replacement therapy can be used if fertility is not an issue. A pituitary tumor may require surgical removal, medication, radiation, or replacement of other hormones.
Assisted Reproduction: While there is often no effective treatment to restore fertility in a man with Primary Male Hypogonadism , assisted reproductive technology can be helpful. This technology encompasses a variety of techniques designed to help couples who have been successful in achieving conception.
treatment for boys
In boys with Male Hypogonadism , testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sexual characteristics, such as increased muscle mass, beard and pubic hair growth, and penis growth. Pituitary hormones can be used to stimulate testicular growth.
Types of Testosterone Replacement Therapy: There are several methods of providing testosterone . Choosing a specific treatment depends on your preference for a particular delivery system, side effects and cost. Methods include:
Injection: Testosterone injections ( testosterone cypionate, testosterone enanthate ) are safe and effective. Injections are given into a muscle. Your symptoms may vary between doses, depending on the frequency of injections.
Testosterone undecanoate , an injection recently approved by the Food and Drug Administration, is injected less frequently but must be administered by a healthcare professional and can have serious side effects.
Patch: A testosterone – containing patch is applied each night to the back, abdomen, upper arm or thigh. The application site is rotated to maintain seven day intervals between applications to the same site to lessen skin reactions.
Gel : There are several gel preparations available with different ways to apply them. Depending on the brand, you want to rub testosterone gel into your skin on your arm or shoulder, apply with an applicator in each armpit (Axiron) or pump on your front and inner thigh.
As the gel dries, your body absorbs testosterone through your skin . Testosterone Replacement Therapy Gel application appears to cause less skin reactions than patches do. Do not bathe or shower for several hours after applying the gel to make sure it is absorbed.
Gum and cheek (buccal cavity): A small putty-like substance, replacing gum and cheek testosterone (Striant) delivers testosterone through the natural depression above your upper teeth, where your gum meets your upper lip (buccal cavity). This product quickly adheres to your gums and allows testosterone to be absorbed into your bloodstream.
Nasal: Testosterone can be pumped into the nostrils as a gel. This option reduces the risk that the medication will be transferred to another person through skin contact . Nasal-delivered testosterone must be applied twice into each nostril three times a day, which can be more inconvenient than other delivery methods.
Implantable Pellets: Pellets containing testosterone (Testopel) are surgically implanted under the skin every three to six months.
Oral testosterone is not recommended for long-term hormone replacement because it can cause liver problems.
Testosterone therapy carries several risks, including contributing to sleep apnea, stimulating benign prostate growth, enlarging breasts, which limits sperm production, stimulating the growth of prostate cancer and the formation of blood clots that form. existing in the veins. Recent research also suggests testosterone therapy may increase the risk of a heart attack.