Male Hypogonadism

Male Hypogonadism

Hypogonadism is characterized by impaired testicular function, which may affect spermatogenesis and/or testosterone synthesis. The symptoms of hypogonadism depend on the degree of androgen deficiency and if the condition develops before or after pubertal development of the secondary sex characteristics.

• Primary (hypergonadotropic) hypogonadism due to testicular failure.
• Secondary (hypogonadotropic) hypogonadism caused by insufficient gonadotropin-releasing hormone (GnRH) and/or gonadotropin (FSH, LH) secretion.
• Androgen insensitivity (end-organ resistance).

Risk Factors

• Genetic factors
• some drugs and hormones
• anabolic steroids,
• Tumors

Treatments

Hormonal treatment

Human chorionic gonadotropin or GnRH is not recommended for the treatment of cryptorchidism in adulthood.

Surgical treatment

In adolescence removal of intra-abdominal testis (with a normal contralateral testis) can be recommended, because of the theoretical risk of later malignancy. In adulthood, a palpable undescended testis should not be removed because it still produces testosterone. Furthermore, correction of bilateral cryptorchidism, even in adulthood, can lead to sperm production in previously azoospermic men.

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