Male hypogonadism: How to regain vitality?

Male hypogonadism is a condition in which the body does not produce enough testosterone or sperm, or both. It can be congenital or caused by trauma or infection. The extent of the effect depends on the cause and the age of onset. So how to treat this medical condition? Follow the article below to get the most useful information.

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• 1. What are the symptoms of male hypogonadism?
• 2. What causes male sexual dysfunction?
• 3. What are the risk factors for male hypogonadism?
• 4. What complications does male sexual dysfunction cause?
• 5. How to diagnose Male hypogonadism?
• 6. How to treat male hypogonadism?

1. What are the symptoms of male hypogonadism?

Impaired sexual function can occur during pregnancy, before puberty, or during adulthood. Symptoms depend on the time of appearance.

In the fetus

If the body does not produce enough testosterone during pregnancy, the external genitalia may be delayed. Depending on the time of onset and the amount of testosterone at the time, a baby may be born with:

• Female genital organs
• Not sure if it's male or female genitals
• Underdeveloped male genitalia

Adolescent

Male hypogonadism can cause delayed puberty or incomplete development or lack of normal features. It can interfere with the following processes:

• Muscle development
• Deep voice
• Increase height and grow beard
• Increase penis and testicle size

Male hypogonadism can also cause:

• My arms and legs are too big for my body
• Development of mammary gland tissue (gynecomastia)

Manhood

In adult males, sexual dysfunction can alter masculinity and impair reproductive function. Early symptoms and signs include:

• Reduced sex drive
• Reduced vitality
• Depression

Over time, people with reduced sexual function may experience the following symptoms:

• Erectile dysfunction
• Infertility
• Reduce hair growth, beard
• Reduced muscle mass
• Gynecomastia
• Osteoporosis

Severe hypogonadism can be emotionally and psychologically altered. When testosterone drops, there can be symptoms similar to menopause in women. Consists of:

• Difficulty concentrating
• Flushing

2. What causes male sexual dysfunction?

Male hypogonadism means that the testicles do not produce enough testosterone. There are two main types of hypogonadism:

• Origin . Also known as primary testicular failure. The cause is a problem in the testicles.
• Secondary . Due to a problem in the hypothalamus or pituitary gland – the area of ​​the brain that stimulates the testes to produce testosterone. The hypothalamus secretes the hormone GnRH, which signals the pituitary gland to secrete the hormones FSH and LH. The LH then signals the testes to secrete testosterone.

Both types of hypogonadism can be inherited or acquired, eg trauma or infection. Sometimes primary and secondary hypogonadism occur simultaneously.

Primary hypogonadism

Common causes of primary hypogonadism include:

• Klinefelter syndrome . The normal male will have 1 X chromosome and 1 Y chromosome. In this syndrome, the male will have at least 2 X chromosomes plus 1 Y chromosome. An extra X chromosome will cause testicular abnormalities, low testosterone.
• Hidden testicles . Before birth, the testicles are located in the abdomen and then move down into the scrotum. Testicles that do not descend into the scrotum at birth are called undescended testicles. If not treated early, it can lead to abnormal testicular function and low testosterone.
• Orchitis due to mumps . Mumps infection during adolescence or adulthood can affect the testicles. Causes testicular dysfunction and low testosterone.
• Iron stasis disease . Too much iron in the blood can cause testicular failure or pituitary dysfunction. Affects testosterone production.
• Testicular trauma . Because the testicles are located outside the abdomen, they are more susceptible to injury. Injury to the testicles during development can cause sexual dysfunction. Injury to one testicle may not decrease testosterone secretion.
• Cancer treatment . Chemotherapy or radiation therapy can affect testosterone and sperm production. The effects are usually temporary, but some may experience lasting infertility. Although many people are able to become fertile again within a few months, it is still advisable to preserve sperm prior to cancer treatment.

Secondary hypogonadism

In secondary hypogonadism, the testicles are normal but function improperly due to hypothalamic, pituitary causes. Causes include:

• Kallmann's syndrome . Is a hypothalamic abnormality. Causes decreased sense of smell and red-green color blindness.
• Pituitary disorders . It is an abnormality of the pituitary gland that causes a decrease in the secretion of the pituitary hormone that stimulates the production of testosterone. Pituitary tumors or other types of brain tumors in the pituitary gland can cause low testosterone. Treatment for brain tumors, such as surgery or radiation therapy, can also affect the pituitary gland and cause hypogonadism.
• Inflammatory disease . Conditions such as sarcoidosis and tuberculosis in the hypothalamus can affect testosterone production.
• HIV/AIDS . HIV/AIDS can cause low testosterone levels by affecting the hypothalamus, pituitary gland, and testes.
• Drugs . Certain medications, such as opiate pain relievers and certain hormones, can affect testosterone production.
• Obesity . May be associated with sexual dysfunction.
• Old age . As we age, testosterone decreases.

3. What are the risk factors for male hypogonadism?

• HIV AIDS
• History of prior chemotherapy or radiation therapy
• Old
• Fat
• Malnutrition

Sexual dysfunction can be inherited.

4. What complications does male sexual dysfunction cause?

Complications of untreated hypogonadism depend on the time of onset – fetal, pubertal, adult. Consists of:

• Abnormal genitalia
• Gynecomastia
• Infertility
• Erectile dysfunction
• Osteoporosis
• Feeling inferior, self-deprecating

5. How to diagnose Male hypogonadism?

Early detection in young children can help prevent delayed puberty. Early diagnosis and treatment in adults helps prevent osteoporosis and other conditions.

Your doctor will do a physical exam and evaluate external sex characteristics, such as pubic hair, muscles, and testicles.

Your doctor will also do a blood test that measures testosterone levels. Testosterone levels vary throughout the day and are usually highest in the morning. So the blood test will usually be done before 10 am, maybe more than 1 day.

If the test shows low testosterone levels, testing to determine the cause in the testicles or pituitary gland will be done. Consists of:

• Measure hormones
• Semen analysis
• Pictures of pituitary gland
• Genetics
• Testicular biopsy

6. How to treat male hypogonadism?

Adults

Testosterone replacement therapy helps bring testosterone levels back to normal. Testosterone will reduce the signs of male hypogonadism such as decreased libido, decreased vitality, decreased hair and beard growth, decreased muscle mass and osteoporosis.

For older adults with low testosterone levels and symptoms of hypogonadism, testosterone treatment is less effective.

During testosterone treatment, your doctor will monitor the effectiveness of your treatment and side effects each year.

Types of testosterone replacement therapy

Oral testosterone is not used to treat hypogonadism because it can cause liver problems. Oral medications also do not keep testosterone levels stable.

Recently the FDA approved the use of oral testosterone Jatenzo, absorbed through the lymphatic system. Liver damage can be avoided compared with other oral drugs.

Other dosage forms include:

• Gel . Apply testosterone to the skin of the arms or shoulders (AndroGel, Testim, Vogelxo) or the anterior inner thighs (Fortesta). The body absorbs testosterone through the skin. Do not shower for several hours after applying the medicine. The side effect is skin irritation. Avoid skin-to-skin contact until the medication is completely dry, or cover the skin after application.
• Injection . Testosterone cypionate and testosterone enanthate intramuscularly or subcutaneously.
• Paste . Testosterone patch (Androderm) is applied to the thigh or torso every night. May cause severe skin irritation.
• Shut up . Suck a testosterone powder on your cheeks and upper jaw. Use 3 times/day. May cause gum irritation.
• Nose spray . Spray 2 sprays in each nostril, 3 times a day. May be more inconvenient than other forms of medication.
• Implant tablets . Testosterone pills (Testopel) are implanted under the skin every 3 to 6 months. This method requires an incision in the skin.

Testosterone therapy has many risks:

• Increased red blood cells
• Pimples
• Gynecomastia
• Sleep disorders
• Prostate Enlargement
• Reduced sperm production

Infertility treatment

If the cause is pituitary, hormones can be used to stimulate sperm production. Pituitary tumors may require surgery, medication, radiation therapy, or other hormone replacement.

There is usually no cure for primary hypogonadism. But assisted reproductive technology can help.

Children

Treatment for delayed puberty depends on the original cause. Parenteral testosterone supplementation for 3 to 6 months can stimulate puberty and the development of secondary sexual characteristics. Such as increased muscle mass, beard growth, pubic hair growth and penis growth .

Male hypogonadism causes low self-esteem and can affect relationships. Determining the cause is an important first step in choosing the most appropriate treatment. If you have symptoms of male hypogonadism, contact your gynecologist for timely examination and treatment.

>> Sperm is the male reproductive cell. It carries the genetic information of half of the father's genome to the child. To give birth to a child requires the fusion of an egg and sperm. See more here 

Doctor Vu Thanh Do