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Geregistreerd op: 21 Jul 2019
Berichten: 195
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Hypogonadism and Testosterone Treatment
Male hypogonadism is a clinical syndrome resulting from inadequate testosterone and/or sperm production from the testis. The presence and severity of the clinical manifestations of hypogonadism depend on the degree, duration, and timing of onset. A careful history, medication review, physical examination, and laboratory evaluation are essential to establish the diagnosis and underlying cause(s).Testosterone Decanoate powder
The prevalence of hypogonadism is enriched in certain populations. A high index of suspicion is prudent regardless of symptoms if the following conditions are present:
End-stage renal disease requiring peritoneal dialysis or hemodialysis
Type 2 diabetes mellitus
Severe chronic obstructive pulmonary disease
Human immunodeficiency virus (HIV)-associated wasting syndrome or lipodystrophy
Pituitary disease or prior sellar radiation/surgery
High risk medications, especially if use is prolonged (e.g., long-acting opioids, high-dose glucocorticoids)Causes of hypogonadism may be separated into diseases of the testis (primary), and diseases of the hypothalamic-pituitary axis (secondary). Diseases of the testis may be further subdivided into combined defects in hormone production and spermatogenesis, and isolated defects in spermatogenesis.
Either acute or chronic systemic illness including HIV, diabetes mellitus, cirrhosis, chronic renal, heart, and liver failure, chronic lung disease, anorexia nervosa, rheumatologic diseases, sickle cell disease, advanced cancer, protein-calorie malnutrition, alcoholism, etc., can cause both primary and secondary hypogonadism by multiple mechanisms.
Aging is not a cause of hypogonadism per se. Although serum testosterone levels decline with age, the decline is typically within the normal range. The increased incidence of hypogonadism in older men is largely attributed to the increased incidence of medical comorbidities.
The differential diagnosis of hypogonadism includes other disorders that may cause sexual dysfunction (poor libido, erectile dysfunction, disorders of orgasm or ejaculation) or infertility. Because many of the symptoms of hypogonadism are nonspecific, and many of these disorders can directly cause sexual dysfunction along with hypogonadism, a careful history is essential. |
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