Hypogonadism

Hypogonadism Hypogonadism

What is hypogonadism?

Hypogonadism is a condition where there are low sex hormones for that particular gender. For example in a male, it is characterized by low testosterone levels and in a woman, it is characterized by low estrogen levels. Testosterone is also responsible for the development of secondary sexual characters. For example, it helps in the development of a beard,mustache, muscular build and deep voice that is associated with a male. It is also responsible for the development of the external genitalia to its full extent and also for performing full dutiful sexual activities which include libido and erection.

Testosterone also in general is required for energy levels in a male and the storm deficiency can be accompanied with decreasing energy levels. In women, optimum levels of estrogen level is also required for the development of secondary sexual characters, including external genetelia and breast development. Functionally, it is also required for good sexual performance and also for development of the female body contours.

What are the symptoms of male hypogonadism?

The symptoms of male hypogonadism are as follows:

  • Males with hypogonadism usually present with poor sexual function. They have poor libido and weak erections. Some of them might develop premature ejaculation leading to reduced sexual satisfaction.  
  • During puberty, there is poor development of facial hair i.e. beard and mustache and hair over the body in males with hypogonadism. 
  • Males will also have poor muscle development and loss of energy as one of the main symptoms of male hypogonadism. 
  • Long standing hypogonadism will ultimately increase the risk of abdominal weight, gain hypertension and cardiovascular disease.

Hypogonadism is one of the common ailments that are treated at Magna Centre for obesity, diabetes and endocrinology. On an average, around 3 to 4 cases of male hypogonadism are treated every week and we now have a experience of more than 10 years in treating male hypogonadism. When one visits with conditions that are suspicious of male hypogonadism, the doctor does a brief clinical examination and will get some tests done. These include the Pituitary hormones and hormones namely LH, FSH, TSH and prolactin. Testosterone that is produced from the testis levels will also be measured.  If the LH and FSH are low, this indicates a pituitary gland problem. Therefore, the doctor would analyze why the pituitary gland is not able to produce these hormones  by doing certain imaging tests.  If the LH and FSH  levels are high, this indicates a primary testicular problem; this also may need some basic investigations to find out why the testes are not able to produce testosterone hormones properly. After diagnosing the basic condition if there is a treatable cause, it will be treated.  

How is Hypogonadism treated at Magna?

If there is no treatable cause, testosterone is usually prescribed. Although, testosterone patches and testosterone tablets are available, the common preferred treatments of testosterone include injectable testosterone which can be given either once in a fortnight or there are certain depot preparations which may be given to a frequency once in 3 months.   After diagnosing the basic condition if there is a treatable cause, it will be treated. To counter the symptoms of hypogonadism, testosterone is usually prescribed. Although all the testosterone tablets are available, the common preferred treatments of testosterone include injectable testosterone which can be given either once in a fortnight or there are certain depot preparations which may be given to a frequency once in 3 months also.

In elderly patients there may be some side effects of testosterone that may be expected, especially a rise in the hemoglobin and increase in the prostate gland size.The doctor will keep a clear and close watch for all the side effects - by doing checks of PSA and Hematocrit while on therapy. Therapy should be guided always by an endocrinologist, as it is important not only to supplement the testosterone but also to understand and monitor for any of these side effects. Although the side effects are not very common, it is important to understand them and follow them up on a regular basis. At Magna Centre, we have qualified endocrinologists for obesity, diabetes and endocrinology. The doctors know how to investigate, when to treat and how to follow patients on testosterone therapy.

What causes male hypogonadism?

Testosterone or the male hormone is produced by certain cells called the Leydig cells present in the testes.Testosterone production is controlled by the production of certain hormones from the master endocrine gland i.e. the pituitary gland. The pituitary gland produces two hormones namely a LH and FSH which have a direct effect on the testosterone production by the testes. Therefore, the causes of hypogonadism can be divided in as follows:

It could be because of problems that are related to the pituitary gland. This is also known as central hypogonadism. The pituitary gland can be affected due to various reasons. Some of the common reasons are as below:

  • Pituitary gland tumors or tumors that are around the pituitary gland.
  • Certain infections that can affect the pituitary gland.

 

In many cases, it can also occur due to functional hypopituitarism. This occurs in cases of severe mental or physical stress. For example, a person who has been under mental stress for a long period of time or is recovering from a prolonged illness can develop functional Hypogonadism which can be reversed with the reversal of the primary condition.

Hypogonadism can also occur due to problems that are directly related to the testicular gland. This can also be because of infections that affect the testes or certain genetic conditions which do not allow the testes to develop properly or it could be acquired for example on tumors of the testes.

Hypogonadism can occur in elderly males where the testicular function will slowly decline as the age progresses. This is more commonly seen in males above 55 to 60 years of age, where because of aging, the testes function slowly and symptoms suggestive of hypogonadism can develop with age.

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