MALE HYPOGONADISM

Male hypogonadism may be primary (due to testicular failure) or secondary ( due to failure of hypothalamus or pituitary).

ETIOLOGY

Primary hypogonadism

• Klinefelter’s syndrome

• Autoimmune gonadal failure

• Mumps orchitis

• Hemochromatosis

• Tuberculosis

• Chemotherapy or irradiation

• Congenital adrenal hyperplasia

• Cryptorchidism

Secondary hypogonadism

• Hypopituitarism

• Kallmann’s syndrome

• Hyperprolactinemia

CLINICAL FEATURES

Loss of libido

Lethargy

Muscle weakness

Decreased frequency of shaving,

Gynaecomastia

Erectile dysfunction

Infertility, or delayed puberty.

INVESTIGATIONS

• Serum testosterone level.

• FSH and LH (high in primary and low in secondary hypogonadism.

« Semen analysis

Chromosomal analysis (karyotyping) to rule out Klinefelter’s syndrome.

MANAGEMENT

Testosterone replacement in primary hypogonadism