Male acquired hypogonadotropic hypogonadism: diagnosis and treatment.

摘要: Abstract Acquired hypogonadotropic hypogonadism (AHH), contrary to congenital (CHH) is characterized by postnatal onset of disorders that damage or alter the function gonadotropin-releasing hormone (GnRH) neurons and/or pituitary gonadotroph cells. AHH thus prevents establishment gonadotropin secretion at puberty, its post-pubertal maintenance. Thus, may prevent puberty appear during pubertal development, but it usually emerges after normal age puberty. Although tumors, particularly prolactinoma, are most common cause, sellar tumors cyst hypothalamus infundibulum, infiltrative, vascular, iron overload and other also cause AHH. Pituitary surgery head trauma cranial/pituitary radiation therapy usual causes The clinical manifestations depend on onset, degree deficiency, rapidity association deficiencies excess. Men with have less stamina, decreased libido, erectile dysfunction strength, a worsened sense well being leading degraded quality life. physical examination if recent onset. Diminished facial, body hair muscle mass, fine facial wrinkles, gynecomastia, hypotrophic testes observed in long-standing complete Spermatogenesis impaired volume ejaculate only when gonadotropins testosterone levels very low. low serum LH FSH concentrations, values inappropriate associated testosterone. In majority patients, inhibin B “normal”. decrease this sertolian indicates severe deficiency. Symptoms, significant deficiency men AHH, improve replacement therapy. Replacement often simple, using an injectable ester as first line treatment. Fertility can be restored rather quickly, provided there no independent primary testicular partner fertile.