Male Hypogonadism Flashcards Preview

RB Y2 Endocrine - 6 Reproductive > Male Hypogonadism > Flashcards

Flashcards in Male Hypogonadism Deck (14)
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1
Q

Male hypogonadism

A

the failure of the testes to produce testosterone, sperm or both

2
Q

features of Male hypogonadism

A

small testes, decreased libido, erectile dysfunction, loss of pubic hair, decreased muscle bulk, increased fat, gynaecomastia, osteoporosis, low mood.

If pre-pubertal: decreased virilization, incomplete puberty, enuchoid body, reduced secondary sex characteristics.

3
Q

primary Male hypogonadism

A

due to testicular failure - high LH and FSH and low testosterone

4
Q

causes of primary Male hypogonadism

A

congenital: Klinefelter’s etc

acquired:

  • testicular tortion/trauma
  • chemo/irradiation

post-orchitis eg mumps, HIV, leprosy

renal failure, liver cirrhosis or alcohol excess

5
Q

secondary Male hypogonadism

A

decreased gonadotrphins (LH and FSH) and low testosterone

6
Q

causes of secondary Male hypogonadism

A
  • Congenital/idiopathic: IHH (including Kallman’s and CAH)
  • Hypopituitarism
  • Hypothalamic or pituitary tumours (prolactinoma – hyperprolactinemia)
  • Kallman’s syndrome
  • Systemic illness (e.g. COPD, HIV), exercise, weight changes, stress
  • Infiltrative disease, e.g. sarcoidosis, haemachromatosis
  • Cranial irradiation/trauma
  • Drugs e.g. anabolic steroids, opiates
    • Prader-Willi syndrome
      *
7
Q

if someone presents with signs and symptoms of hypogonadism, what does one do

A

measure total testosterone concentration in semen in morning

if testosterone is normal, hypogonadism is unlikely

if <9.7/10.4 nmol/L, repeat measurement and also measure SHBG

if still low, measure LH and FSH

= primary/secondary hypogonadism

8
Q

Klinefelter’s syndrome

A

the most common congenital cause of primary hypogonadism in men

47XXY or mosaicism

9
Q

what are the clinical features of Klinefelter’s syndrome

A

reduced testicular volume (small testes)

gynaecomastia

eunuchoidism

decreased cognition, libido and sexual maturation

azoospermia

10
Q

eunuchoidism

A

tall with disproportionate arms and legs

indicating low levels of testosterone

11
Q

azoospermia

A

semen contains no sperm due to lack of transport via the vas deferens, is assoicated with infertility

Klinefelter’s syndrome

12
Q

testosterone replacement in men

A

there is clear evidence for this in young men

the evidence for it in older men is less robust

there is controversy on the role of testosterone on CV risk

13
Q

will testosterone restore fertility

A

no

it may act as a contraceptive due to the inhibitory actions on FSH and LH

14
Q

health benefits of testosterone

A

improved sexual function: improved erectile function

bone health: improved spine and hip BMD

body composition/muscle strength - decreaesd fat mass and improved limb strength

QOL and cognition