A full-fledged work of a man's body cannot be imagined without the adequate functioning of the gonads, the production of hormones by them. 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 reference books there are many definitions of such a violation. For example, androgen deficiency or testicular insufficiency. However, among them, the most correct and most accurate is the concept of "hypogonadism" in men. What this condition implies, for what reasons it occurs, whether it can be cured - these questions are answered in detail in today's article.
Brief description of the disorder
Hypogonadism is a disease characterized by functional inferiority of the gonads. In the representatives of the stronger sex, they are represented by the left and right testicles. Nature has specifically provided for their paired number. Testicular tissue is sensitive to harmful environmental factors. In case of loss of functional abilities, the bodyshould have some kind of reserve. The regenerative capacity of the testicles is very modest.
Their main purpose is reproduction. The lack of the ability to produce sperm deprives the male body of the possibility of reproduction. The mechanisms of such violations are laid down at the initial stage of the reproductive cycle. Therefore, infertility that develops 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 decline in sex hormone levels;
- reduction of qualitative and quantitative characteristics of seminal fluid;
- underdevelopment of the genital organs;
- 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. The most commonly used hormone therapy. If it is ineffective, surgery is prescribed for plastic surgery and prosthetics of the organs of the reproductive system.
Main causes of 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 anomalies due toa change 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);
- radio or chemotherapy;
- prolonged use of hormonal, antibacterial drugs;
- diseases of infectious genesis (orchitis after measles, mumps, vesiculitis);
- varicose veins;
- living in an environmentally unfriendly area.
The causes of hypogonadism in men determine the forms of the pathological process. Each of them is characterized by a certain course.
Types of violations
Depending on the underlying cause, gonadal insufficiency is divided into primary, secondary and so-called age-related. How do they differ from each other? The primary form of the disease is otherwise called testicular pathology. In this case, the malfunction of the testicles 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 circuit. 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 disease occurred. The embryonic form is characterized by the appearance of a pathological process during uterine development. Prepubertal is diagnosed before the onset of puberty (up to about 14 years). Postpubertal variantdisease occurs after the completion of the development of secondary sexual characteristics.
Given the amount of androgens produced, the following types of the 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 testicles, but the production of pituitary hormones remains within the normal range. The disease is often associated 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 pathology remains unknown.
Primary hypogonadism
The disease can be both acquired and congenital. Most often, 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 are found to be overweight, the initial manifestations of gynecomastia and a low degree of hair growth.
Acquired primary hypogonadism in men develops against the background of inflammation of the seminalglands 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 hormones of the pituitary and hypothalamus. It often accompanies the following genetic disorders:
- Prader syndrome - Willy;
- 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 are meningitis, arachnoiditis and encephalitis.
Symptoms of illness 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;
- appearance of symptoms of eunuchoidism (excessively tall, small shoulders, long limbs);
- no folds on the scrotum;
- small penis size;
- gynecomastia.
If you have one or more of the symptoms from the list above, you should immediately seek advice from a specialized specialist.
Symptoms of illness in adolescents
Development of the disease in adolescenceage 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 young men clearly show underdevelopment of the muscular system.
Symptoms of illness in adults
Hypogonadism in men over 30 is less pronounced. The disease is accompanied by the appearance of multiple fatty folds on the body. Over time, the skin loses its former elasticity, becomes dry. There is rapid fatigue, emotional lability, a tendency to depression. Unfortunately, representatives of the stronger sex go to the hospital in exceptional cases. Usually when it comes to infertility or erectile dysfunction.
Such inattention to one's own he alth can result in serious consequences. The pathological process begins to spread not only to the reproductive system, but gradually passes to other organs and tissues. Lack of competent therapy can lead to disability.
Diagnostic Methods
One should not be afraid of the diagnosis of hypogonadism in men ahead of time. What this condition means, the doctor should tell at the first consultation. After all, when symptoms of the disease appear, you should immediately contact a qualified specialist. Despite the rather bright clinical picture, a clinical examination will be required to confirm the disease. It includesthe following activities:
- physical examination;
- Ultrasound of the pelvic organs;
- karyotype study;
- urinalysis;
- spermogram;
- blood test for hormones.
Examination is scheduled for each patient individually. Therefore, the list of clinical activities 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 disease. The treatment of hypogonadism in men usually has several goals: the fight against the underlying disease, the prevention of infertility, the prevention of neoplasms in the testicular tissue.
Congenital and prepubertal forms of pathology are often accompanied by infertility. It is not possible to eliminate this problem. If testicular endocrinocytes are preserved, 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 medicinesprescribed individually, taking into account the state of he alth and age of the patient. In some cases, the use of replacement therapy using hormonal agents is not recommended. For example, with cancer of the prostate gland. Chronic lung diseases, smoking, impaired fat metabolism and sleep apnea are relative contraindications. In these situations, the decision to take testosterone drugs is made individually.
Surgery
If hypogonadism in a man is caused by physical abnormalities in the development of the genital organs, an operation is indicated. Today, various intervention options are used to eliminate the pathology. For example, in case of underdevelopment of the penis, phalloplasty is used, in the case of cryptorchidism, the testicle is brought down. To eliminate a cosmetic defect, a synthetic testicle is implanted. Any of the above operations is carried out using microsurgical techniques.
Prognosis for recovery
Primary hypogonadism, especially congenital, can be partially corrected. We are talking about the restoration of the anatomical and functional abilities of the penis. However, modern medicine cannot normalize ejaculation. The only option to return the lost reproduction is IVF through the collection of spermatozoa. In this case, intratesticular spermatogenesis must be preserved.
A different prognosis awaits patients diagnosed with secondary hypogonadism. In men, the treatment of this disease in most cases gives positive results.results. Therefore, doctors most often manage to restore reproductive function.
Prevention 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, no bad habits, exercise;
- passing the examination at the "male" doctors for preventive purposes once a year.
The above tips, unfortunately, do not always prevent hypogonadism in men. At the first manifestations of it, you should immediately seek help from a specialist. The sooner the doctor prescribes therapy, the faster the recovery process will go.
