HYPOGONADISM

Question 1

if the condition is “primary” where will you see the issue?

Answer 1

with the gonads themselves

Question 2

in primary hypogonadism what occurs regarding the gonads?

Answer 2

the gonads do not produce enough sex hormone to suppress the pituitary’s secretion of FSH and LH.

Question 3

in primary hypogonadism condition what will FSH and LH be doing?

Answer 3

increasing in attempt to stimulate gonads

Question 4

if the condition is “secondary” where will the problem be?

Answer 4

1. in the hypothalamus not producing enough GnRh
2. pituitary that fails to respond to secretion of LSH or FSH.

Question 5

What do you measure first in hypogonadism?

Answer 5

1. FSH and LH

Question 6

what lab values indicate hypergonadotrophic hypogonadism (PRIMARY)

Answer 6

high FSH and LH

Question 7

what lab values indicate hypogonadotrophic hypogonadism (SECONDARY)

Answer 7

low FSH and LH

Question 8

what happens to males who develop hypogonadism before the onset of puberty and are not treated?

Answer 8

no body hair or beard characteristic of other men in the family, temporal hair recession, full male musculature, or deep voice.
- small testes (<20 mL) and small phallus

Question 9

what happens to males who develop hypogonadism after puberty?

Answer 9

they may lose the characteristics talked about in hypogonadism pre-puberty if severe enough and/or of sufficient duration (usually years)
-testes will decrease in size if primary hypogonadism, damaging seminiferous tubules

Question 10

do testes decrease in secondary hypogonadism?

Answer 10

not to a recognizable degree
phallus doesn’t decrease either

Question 11

When do symptoms of hypogonadism begin?

Answer 11

a few weeks within onset of testosterone deficiency

Question 12

what are the common symptoms of hypogonadism?

Answer 12

decreased vigor & libido, depressed mood
- decreased muscle mass and body hair are less common but do not occur for a year or many years)

Question 13

what symptom occurs when the degree of hypogonadism is severe and especially when the rate of fall is rapid?

Answer 13

hotflashes

Question 14

what 2 symptoms are more likely to occur in primary hypogonadism than secondary?

Answer 14

gynecomastia and infertility

Question 15

what is the rise in testosterone prescriptions due to?

Answer 15

direct-to-consumer-advetising (DTCA) encouraging use of testosterone from non specific symptoms such as fatigue and sexual interest

Question 16

what are the 3 reasons for low testosterone?

Answer 16

1. obesity -> if u lose weight-> SBHG decreases and testosterone increases
2. opioid use d/t chronic narcotic regimen affecting pituitary or hypothalamus
3. sleep issues -> hypothalamus regulates sleep. when sleeping is off, cortisol increases
   (sleep apnea- very low testosterone.. not producing enough GnRH)

Question 17

what are the 3 hypogonadism treatment options?

Answer 17

1. transdermal- testim, androgel, fortesta (least control; worst option tbh)
2. pellets- 2-6 testosterone pellets placed in subdermal fat
3. injections- once every 1-2 weeks ( most control)

Question 18

what is SBHG correlated with

Answer 18

amount of adipose tissue