The concept of hypogonadism
Hypogonadism - a pathological condition due to insufficient secretion of androgens (male genital hormones) or a decrease in sensitivity to them.
In the development of hypogonadism, congenital underdevelopment of the genital glands, toxic, infectious, radiation lesion, violation of the function of the hypothalamicpofizar system.
The development of hypogonadism is associated with a decrease in the secretion of sex hormones with testicles. In the primary guimagonadism, a gentle tissue fabric is affected directly, with secondary - hypofunction of the sex glands arises due to the lesion of the hypothalammopofizar system (tumor, neuroinfection, etc.) with a decrease in the gonadotropic function of the pituitary.
Symptoms of the disease
The manifestations of hypogonadism depend on the age in which the disease arose, and the degrees of androgenic failure. Distinguish the apparent and postpubertal forms of hypogonadism. Under the lesion of the testicles before puberty, a typical eunuchoid syndrome develops, which is characterized by a high disproportionate growth due to the delay of the ossification of growth zones, lengthening limbs, underdevelopment of the chest and shoulder belt. Skeletal musculature developed weakly, subcutaneous fatty fiber is distributed to the female type.
With true gynecomastics, the skin of the pale, there is a weak development of secondary sexual signs - the absence of exhaustion on the face and body (on the pubis - on the female type), larynx underdevelopment, high voice. The genitals are underdeveloped - sexual member of small sizes, the scrotum is formed, but depigmented, without folds, testicles are hypoplasized, the prostate gland is underdeveloped, often palpatorically not determined.
In case of secondary hypogonadism, except for the symptoms of androgen deficiency, it is often obesity, it is often obesity, the symptoms of the pitipofunction of other glands of the internal secretion - the thyroid, the adrenal cortex (the result of the loss of trop hormones of the pituitary. Can be observed symptoms of pangipopituitarism. Poland and potency are absent.
If the fraction of the function of the testicles occurred after puberty, when the sexual development and the formation of the joyful system are already over, the symptoms of the disease are less pronounced. The decrease in the testicles, a decrease in the fragmentation of the face and body, thinning of the skin and the loss of its elasticity, the development of obesity on the female type, violation of sexual functions, infertility, vegetual disorders.
Diagnosis of hypogonadism
The diagnostics uses x-ray and laboratory data. In hypogonadism, which developed to the period of puberty, marked lag «bone» age from passport for several years. Testosterone blood content below normal. To diagnose the level of the lesion, a sample is carried out with chorionic gonadotropin - with primary hypogonadism, the testosterone level does not change, with secondary - increases. In primary hypogonadism - an increase in the level of gonadotropins in the blood, with a secondary - its decline, in some cases their content can be within the normal range. When analyzing the ejaculate - there is a decrease in the number of spermatozoa or their complete absence, in some cases the ejaculate cannot be obtained.
Forecast and treatment of the disease
Life forecast favorable. Chronic disease, in the treatment process, it is possible to reduce the symptoms of androgenic failure.
For treatment, replacement therapy with testosterone preparations (Testanat, Suiston 250, Omnadrene 250), which is constantly being held. In secondary hypogonadism, an incentive therapy of a chorionic gonadotropin of 1500-3000 units is prescribed 23 times a week with courses over a month with monthly interruptions or therapy with chorionic gonadotropin in combination with androgen. Showing a common therapy, therapeutic physical education.