Hypogonadism MEN – it untill sufficiency or lack of reproductive organs in men, particularly the testicles.
There are two main odds we hypogonadal male (GM):
Primary cases are those when the pathological process is concentrated in the testicles themselves. Secondary – when the initial abnormal about the process of the testicles is outside, often in the system diencephalic-pituitary IU, in the bodies that regulate the function tion testicular Adreno -genitalny syn core, gipokortitsizm , gipotire Lake, inadequate secretion of luteinizing hormone (LH) hypo fizom.
Among the causes of hypogonadism male pervostepen Noah importance should be given to hereditary governmental factor.
The etiopathogenesis of hypogonadism male Genetic sky factor is reschayuschee zna chenie, but the study of chromosomes karyotyping of today is not yet at a level that, in all cases, it could dock to show. Only when anomalies X- and Y- xpomosom we are able to accurately diagnose certain nekoto rye deviation – Turner’s syndrome, Klinefelter’s and others.
The cause of primary hypogonadism male testicular trauma can be obtained in early childhood infection, In particular STI viral parotitis, orchitis , epididymitis, gonorrhea, hydrocele , vari Koznov veins of the spermatic cord, damage or compression seminiferous tubule after Plays zhesecheniya , X-ray irradiation .
For the occurrence of secondary hypogonadism in addition to hereditary facto ditch play a role skull trauma endured in healing it childhood CNS .
Although in each case the mouth ment of the initial localization of the pathological process before stavlyaet a difficulty, but it is possible if made the necessary clinical and laboratory X-ray examinations: history, hereditary data en tropometriya, study general somatic status and others.
Hormonal basis of hypogonadism male, both primary and secondary, in to a finite result is the lack of production of androgen hormones, particularly testosterone. It should be noted that often the daily excretion of urine metabolites of androgens 17-KS with urine may be normal, however, the patient has obvious hypogonadism . This is because the normalized minimum quantity of a daily urinary 17-KS achieved due maloak tive androstenedione and testosterone is not active. In addition, having are evidence that inactive androstenedione has some inhibiting property of the secretion of gonadotropin-releasing hormone (TG). Studies in recent years show that hypogonadism sharply reduced testosterone secretion and significantly enhanced the secretion of an drostendiona , their ratio of 4: 1 is normal may be 1: 2.
Clinic hypogonadism male in many ways similar to its various forms: impotence, decreased or lack of libido, hypoplasia of the testes, penis, scant or no ovo loseniya on the face, suprapubic of fins, on the chest, often eunuchoid or gynoid physique, weak muscles and Su hozhilnogo apparatus, an ultra small joints, the plane PIE, osteoporosis, in this regard, bo there in the bones and joints. Often there is a number of extragenital syndromes in connection with the switching off of the tonic effect of sex hormones on the central nervous system, which is expressed by neuropsychic disorders, decreased mental abilities, and disability. Patients are usually shy, limp.
Due to the decreased secretion of sex hormones, anabolic processes are also reduced. Along with muscle weakness of the system is weakly developed and the myocardium – often observe a vertical drop heart (myocardial), cardioneurosis , tachycardia, vascular paging, akrozianoz .
The development of the above symptoms largely depends on the time of occurrence of pathological Skog process: embryonic, prepubertal or postpubertal . Of course, the sooner they fuss cabins, the clearer and sharper expressed wife symptoms.
Classification of male hypogonadism .
Classification of hypogonadism are not committed to, and inconsistent. Below reducible ditsya working classification of hypogonadism endocrine origin, koto paradise, in our opinion, will help ka Coy extent meet prac cal requirements.
A. Primary hypogonadism :
- Anorchism (testicular aplasia).
- Testicular hypoplasia ( hyporchism – insufficiency of testicular function).
- Del Castillo Syndrome
- False Klinefelter Syndrome
- Post-puberty hypogonadism
B . Hypogonadism secondary:
- Hypothalamic-pituitary origin with a deficiency of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) ( hypogonadotropic eunuchoidism)
- Hypogonadotropic hypogonadism with a deficiency of luteinizing hormone ( hypogonadism with spermatogenesis).
- Hypogonadotropic hypogonadism in connection with panhypopituitarism (pituitary pituitary function).
- Adipose-genital dystrophy
- Based on hormone-non-producing ( chromophobic ) pituitary tumors.
- Hypogonadism with nanism
B. Hypogonadism due to chromosomal abnormality:
- Klinefelter’s syndrome.
- Shereshevsky-Turner syndrome
- True hermaphroditism
G. Other types of male hypogonadism :
- Adrenal Genital Syndrome
- Itsenko- Cushing’s syndrome
- Hypothyroid (see. Hypothyroidism).
- Incomplete testicular feminization.
The classification is not included due to a pathology arising urogogenitalnoy system functional nye, infectious toxic, ray high, and involutionally-Klimakov tericheskie et al. Shapes gipogona dizma .