Hypogonadism in men: symptoms and treatment

A full-fledged work of the body of a man can not be imagined without the adequate functioning of the gonads, the production of hormones. Any failure in this system entails the appearance of somatic diseases. Dyslipidemia, atherosclerosis, obesity, brain ischemia is not the whole list of possible complications. In medical reference books there are many definitions of such a violation. For example, androgen deficiency or testicular failure. However, among them the concept of "hypogonadism" in men is considered the most correct and most accurate. What this condition means, for what reasons arises, whether it can be cured - these questions are presented with detailed answers in today's article.

Brief description of the disorder

Hypogonadism is a disease characterized by functional infertility of the sex glands. The representatives of the stronger sex are represented by a left and right testicle. Nature specifically provided for a pair of their number. Testicular tissue is sensitive to harmful environmental factors. In case of loss of functional abilities the organism should have a kind of reserve. The regenerative capacity of the testicles is very modest.

Their main purpose is reproduction. The lack of ability to produce spermatozoa deprives the male organism of the possibility of reproduction. The mechanisms of such violations were 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 sexual organs;
• Violation of the hormonal background throughout the body.

According to statistical data, the syndrome of hypogonadism in men occurs in 1% of the world's population. However, this information is arbitrary, since only registered cases of pathology are taken into account. Treatment is necessarily carried out under the control of the endocrinologist and andrologist. The most commonly used hormone therapy. If it is ineffective, surgery for plastic surgery and prosthetics of the genital system 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 biosynthesis disorder. To etiological factors of the disease can be attributed:

• Congenital anomalies due to changes in the structure of the testicles and / or seminal tubules;
• The effect of toxins on the organism of the future woman in labor (alcohol, nicotine, narcotic substances);
• Radiation or chemotherapy;
• Long-term use of hormonal, antibacterial drugs;
• Diseases of infectious genesis (orchitis after measles, mumps, vesiculitis);
• Varicose veins;
• Living in an area with an unfavorable ecological situation.

The causes of hypogonadism in men cause the forms of the pathological process. Each of them is characterized by a definite current.

Varieties of violation

Depending on the root cause of insufficiency of the genital glands is divided into primary, secondary and so-called age. How do they differ among themselves? The primary form of the disease is otherwise called testicular pathology. In this case, disruption of the testicles occurs under the influence of negative factors from the outside. Secondary hypogonadism in men is associated with anomalies in the work of the "pituitary-hypothalamus" scheme. This system through the produced hormones is responsible for the functioning of the testes. Age variant of the disease is considered a kind of male climax. The reasons for his appearance, doctors can not explain until now.

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 in the period of 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 number of produced androgens, the following types of disease are distinguished:

1. Hypergonadotropic hypogonadism. In men, this form of the disease manifests itself in the form of a testicular testicular tissue. It is accompanied by an increased production of pituitary hormones. At the same time, testosterone levels are significantly reduced.
2. Hypogonadotropic hypogonadism. It is characterized by a decrease in the synthesis of gonadotropins. As a result, the amount of testosterone produced is reduced.
3. Normogonadotropic hypogonadism. In men, this form of pathological process leads to disruption of the testicles, but the production of pituitary hormones remains within normal limits. 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 reason for the appearance of pathology remains unknown.

Primary hypogonadism

The disease can be either acquired or congenital. Most often, pathology occurs in the intrauterine 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 excessive body weight, initial manifestations of gynecomastia, and a low degree of hairiness.

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 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 and hypothalamus. It often accompanies the following genetic disorders:

• The Prader-Willy syndrome;
• Maddock's syndrome;
• Paskualini's syndrome.

The acquired form of the disease is usually a consequence of inflammatory processes in the membranes of the brain. They include meningitis, arachnoiditis and encephalitis.

Symptoms of the disease in young children

The clinical picture of the pathological process is largely determined by the age of the patient. Development of it from an early age is usually accompanied by the following symptoms:

• Disorder of puberty;
• The appearance of symptoms of eunuchoidism (excessive height, small shoulders, long limbs);
• Absence of creases on the scrotum;
• Small size of the penis;
• Gynecomastia.

If you have one or more symptoms from the list above, you should immediately seek advice from a specialized specialist.

Symptoms of the disease in adolescents

The development of the disease in adolescence is characterized by the same symptoms as in the prepubescent period. The clinical picture can be complemented by a decrease in libido and overweight. When referring to a doctor, hypofunction of the adrenal glands and thyroid gland is usually detected. Outwardly, the underdevelopment of the muscular system is distinctly manifested in sick young men.

Symptoms of the disease in adults

Hypogonadism in men over 30 is less pronounced. The disease is accompanied by the appearance of multiple fatty folds on the body. Skin over time lose its former elasticity, become dry. There is rapid fatigue, emotional lability, a tendency to depression. Unfortunately, the representatives of the stronger sex are referred to the hospital in exceptional cases. Usually when it comes to infertility or a breakdown of erectile function.

This 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 shifts to other organs and tissues. Lack of proper therapy can lead to disability.

Methods of diagnosis

Do not be afraid of the diagnosis of hypogonadism in men before the time. What this condition means, the doctor should tell at the first consultation. After all, when symptoms of an illness appear, you should immediately contact a qualified specialist. Despite a rather bright 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 karyotype;
• Analysis of urine;
• Spermogram;
• A 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 obtained, the doctor confirms or refutes the preliminary diagnosis, prescribes therapy.

Features of treatment

The choice of a specific method of therapy remains with the doctor and is determined taking into account the cause of the ailment. Treatment of hypogonadism in men usually pursues several goals: fighting the underlying disease, preventing infertility, preventing the appearance of tumors in the testicular tissue.

Congenital and prepubertal forms of pathology are often accompanied by infertility. Eliminate this problem is not possible. If endocrinocytes in the testicles are preserved, stimulating therapy is recommended. Children are prescribed non-hormonal medications, and adults - necessarily androgens. In the absence of endocrine cells, hormone drugs should be drunk throughout life.

In the secondary form of the pathological process, gonadotropic medications 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 medicines are prescribed individually, taking into account the patient's health and age. In some cases, the use of hormone replacement therapy is not recommended. For example, with oncological lesions of the prostate gland. Chronic lung diseases, smoking, disorders of fat metabolism and apnea attacks are relative contraindications. In these cases, the decision to take testosterone drugs is taken individually.

Surgical intervention

If hypogonadism in a man is caused by physical abnormalities in the development of genital organs, the operation is indicated. Today various pathways are used to eliminate pathology. For example, when the penis is underdeveloped, phalloplasty is used, in the case of cryptorchidism, the testicle is lowered. Implantation of the synthetic testicle is performed to eliminate the cosmetic defect. Any of these operations is carried out using microsurgical techniques.

Prognosis for recovery

Primary hypogonadism, especially congenital, can be partially corrected. It's about restoring the anatomical and functional abilities of the genital organ. However, ejaculation of modern medicine can not be normalized. The only option is to return the lost reproduction - ECO by sampling the spermatozoa. In this case, intra-lactic spermatogenesis should be preserved.

Another prognosis awaits patients with a diagnosis of secondary hypogonadism. In men, treatment of this disease in most cases gives positive results. Therefore, doctors often manage to restore the 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 diseases;
• Proper nutrition, the absence of addictions, sports;
• Passing the examination of "male" doctors for preventive purposes once a year.

These tips, unfortunately, do not always allow you to prevent hypogonadism in men. At its first manifestations, one should immediately seek help from a specialist. The sooner a doctor prescribes therapy, the sooner the process of recovery will go.