It is impossible to imagine the full-fledged work of the man’s body without the adequate functioning of the sex glands, their production of hormones. Any failures in this system entail the appearance of somatic diseases. Dyslipidemia, atherosclerosis, obesity, cerebral ischemia - this is not the whole list of possible complications. In medical directories, there are many definitions of such a violation. For example, androgen deficiency or testicular insufficiency. However, among them, the concept of “hypogonadism” in men is considered the most faithful and most accurate. What this condition implies, for what reasons it arises, whether it can be cured - these questions provide detailed answers in today's article.
A brief description of the disorder
Hypogonadism is a disease characterized by functional inferiority of the gonads. In representatives of the stronger sex, they are represented by the left and right testicle. Nature specifically provided for their paired number. Testicular tissue is sensitive to environmental hazards. In case of loss of functional abilities, the body must have a kind of reserve. The regenerative ability of the testicles is very modest.
Their main purpose is reproduction. The lack of ability to produce sperm deprives the male body of the ability to reproduce. The mechanisms of such disorders are laid down at the initial stage of the reproductive cycle. Therefore, infertility developing against this background is considered very dangerous. It is almost impossible to restore the function of pathologically altered elements of testicular tissue.
Hypogonadism in men is characterized by the following features:
- gradual decrease in the level of sex hormones;
- reduction of qualitative and quantitative characteristics of seminal fluid;
- underdevelopment of the genitals;
- hormonal imbalance throughout the body.
According to statistics, hypogonadism syndrome in men occurs in 1% of the world's population. However, this information is conditional, since only registered cases of pathology are taken into account. Treatment is necessarily carried out under the supervision of an endocrinologist and andrologist. Hormone therapy is most commonly used. If it is ineffective, surgery for plastic and prosthetic reproductive organs is prescribed.
The main causes of the disease
The development of the pathological process occurs as a result of a decrease in the number of hormones produced or a violation of biosynthesis. The etiological factors of the onset of the disease include:
- congenital malformations due to changes in the structure of the testicles and / or seminiferous tubules;
- the effect of toxins on the body of a future woman in labor (alcohol, nicotine, narcotic substances);
- conducting radiation or chemotherapy;
- prolonged use of hormonal, antibacterial drugs;
- infectious diseases (orchitis after measles, mumps, vesiculitis);
- testicular varicose veins;
- living in an area with adverse environmental conditions.
The causes of hypogonadism in men determine the forms of the pathological process. Each of them is characterized by a specific course.
Types of violation
Depending on the root cause of the occurrence, the gonadal insufficiency is divided into primary, secondary, and so-called age-related. How do they differ among themselves? The primary form of the disease is also called testicular pathology. In this case, the disruption of the testes occurs under the influence of negative factors from the outside. Secondary hypogonadism in men is associated with abnormalities in the work of the pituitary-hypothalamus scheme. This system through the produced hormones is responsible for the functioning of the testicles. The age-related variant of the disease is considered a kind of male menopause. Doctors still cannot explain the reasons for its appearance.
The following classification is based on the period of life in which the ailment arose. The embryonic form is characterized by the appearance of a pathological process during uterine development. Prepubertal is diagnosed before puberty (up to about 14 years). The post-pubertal variant of the disease occurs after the completion of the development of secondary sexual characteristics.
Given the amount of androgens produced, the following types of disease are distinguished:
- Hypergonadotropic hypogonadism. In men, this form of the disease manifests itself in the form of damage to the testicular tissue of the testicles. It is accompanied by increased production of pituitary hormones. At the same time, testosterone levels are significantly reduced.
- Hypogonadotropic hypogonadism. It is characterized by a decrease in the synthesis of gonadotropins. As a result, the amount of testosterone produced is reduced.
- Normogonadotropic hypogonadism. In men, this form of the pathological process leads to disruption of the testes, but the production of pituitary hormones remains within the normal range. The disease is often combined with obesity.
Depending on the etiology, it is customary to distinguish congenital, acquired and idiopathic forms. In the latter case, the main cause of the appearance of the pathology remains unknown.
Primary hypogonadism
The disease can be either acquired or congenital. Most often, the pathology occurs in the prenatal period. The boy is born with a small penis and an underdeveloped scrotum. As the disease progresses, the clinical picture changes. In adolescence, young men with this diagnosis show excess body weight, initial manifestations of gynecomastia, and a small degree of hair growth.
Acquired primary hypogonadism in men develops against the background of inflammation of the seminal glands in the following disorders:
- orchitis;
- vesiculitis;
- epididymitis;
- piggy;
- chickenpox.
This form of the disease is considered the most common. It occurs in every fifth man with previously identified infertility.
Secondary hypogonadism
Secondary hypogonadism can also be congenital or acquired. In the first case, the development of the disease is preceded by a violation of the secretion of the hormones of the pituitary gland and hypothalamus. She often accompanies the following genetic disorders:
- Prader-Willi syndrome;
- Maddock syndrome;
- Pasqualini syndrome.
The acquired form of the disease is usually the result of inflammatory processes in the membranes of the brain. Among them, meningitis, arachnoiditis and encephalitis can be distinguished.
Symptoms of the disease in young children
The clinical picture of the pathological process is largely determined by the age of the patient. Its development from an early age is usually accompanied by the following symptoms:
- puberty disorder;
- the appearance of symptoms of eunuchoidism (excessively high growth, small shoulders, long limbs);
- lack of folds on the scrotum;
- small size of the penis;
- gynecomastia.
If you have one or more symptoms from the list above, you should immediately consult a specialist.
Symptoms of the disease in adolescents
The development of the disease in adolescence is characterized by the same symptoms as in the prepubertal period. The clinical picture can be supplemented by a decrease in libido and overweight. When contacting a doctor, hypofunction of the adrenal glands and thyroid gland is usually detected. Outwardly, sick youth clearly shows underdevelopment of the muscular system.
Symptoms of the disease in adults
Hypogonadism in men over 30 years of age is less pronounced. The disease is accompanied by the appearance of multiple fatty folds on the body. The skin over time lose their former elasticity, become dry. Fatigue, emotional lability, and a tendency to depression appear. Unfortunately, representatives of the stronger sex turn to the hospital in exceptional cases. Usually when it comes to infertility or erectile dysfunction.
Such inattention to one’s own health can result in serious consequences. The pathological process begins to spread not only to the reproductive system, but gradually switches to other organs and tissues. Lack of proper therapy can lead to disability.
Diagnostic Methods
One should not be scared ahead of time of the diagnosis of hypogonadism in men. What this condition means should be told by the doctor at the first consultation. After all, with the onset of symptoms of an ailment, you should immediately contact a qualified specialist. Despite the rather vivid clinical picture, a clinical examination will be required to confirm the disease. It includes the following activities:
- physical examination;
- Ultrasound of the pelvic organs;
- study of the karyotype;
- Analysis of urine;
- spermogram;
- blood test for hormones.
The examination is assigned for each patient individually. Therefore, the list of clinical events may vary slightly. Based on the results, the doctor confirms or refutes the preliminary diagnosis, prescribes therapy.
Treatment features
The choice of a specific method of therapy remains with the doctor and is determined taking into account the cause of the disease. The treatment of hypogonadism in men usually has several goals: the fight against the underlying disease, the prevention of infertility, and the prevention of neoplasms in the testicular tissue.
Congenital and prepubertal forms of pathology are often accompanied by infertility. To eliminate this problem is not possible. If endocrinocytes are preserved in the testes, stimulation therapy is recommended. Non-hormonal medications are prescribed for children, and androgens are required for adults. In the absence of endocrinocytes, you need to drink hormonal drugs throughout your life.
In the secondary form of the pathological process, gonadotropic drugs are prescribed in a small dosage. If necessary, they are combined with testosterone. A certain role in the treatment of the disease belongs to exercise therapy and the intake of vitamin complexes.
All drugs are prescribed individually, taking into account the health status and age of the patient. In some cases, the use of hormone replacement therapy is not recommended. For example, with cancer of the prostate gland. Chronic lung diseases, smoking, impaired fat metabolism and apnea attacks are relative contraindications. In these situations, the decision to take testosterone preparations is made individually.
Surgical intervention
If hypogonadism in a man is caused by physical abnormalities in the development of the genital organs, surgery is indicated. Today, various options for intervention are used to eliminate pathology. For example, with underdevelopment of the penis, phalloplasty is used, in the case of cryptorchidism, the testicle is reduced. To eliminate a cosmetic defect, a synthetic testicle is implanted. Any of these operations is carried out using microsurgical techniques.
Prognosis for recovery
Primary hypogonadism, especially congenital, can be partially corrected. It is about restoring the anatomical and functional abilities of the penis. However, ejaculation in modern medicine cannot be normalized. The only option to regain lost reproduction is IVF through sperm collection. At the same time, intra testicular spermatogenesis must be preserved.
Another prognosis awaits patients with a diagnosis of secondary hypogonadism. In men, the treatment of this disease in most cases gives positive results. Therefore, doctors most often manage to restore reproductive function.
Preventive measures
Specific prevention of this disease has not been developed. Among the general recommendations, doctors call the following:
- timely treatment of any disease;
- proper nutrition, lack of addictions, exercise;
- examination by “male” doctors as a preventive measure once a year.
These tips, unfortunately, do not always prevent hypogonadism in men. At its first manifestations, you should immediately seek help from a specialist. The sooner the doctor prescribes therapy, the faster the healing process will go.