Hypogonadism Questions & Answers

Updated: Apr 03, 2019
  • Author: Maria G Vogiatzi, MD; Chief Editor: George T Griffing, MD  more...
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Questions & Answers

Overview

What is hypogonadism, and what is the morbidity?

What are the causes of hypogonadism?

What is the focus of the evaluation for hypogonadism in males?

What is the focus of evaluation for hypogonadism in females?

What is included in the physical exam of hypogonadism in males?

What is included in the physical exam of hypogonadism in females?

Which lab studies are performed in the evaluation of hypogonadism in males?

Which lab studies are performed in the evaluation of hypogonadism in females?

Which tests may be clinically indicated for the evaluation of hypogonadism?

What is the primary treatment for hypogonadism?

What are the treatment options for men with hypogonadism when fertility is desired?

What is the risk for prostate cancer from transdermal testosterone treatment for hypogonadism?

How is hypogonadism manifested differently in males and females?

What is the physiology of hypogonadism?

What is the difference in the pathophysiology of hypergonadotropic hypogonadism and hypogonadotropic hypogonadism?

What is the role of genetics in the pathophysiology of hypogonadism?

What is the incidence of hypogonadism?

What is the prevalence of hypogonadism in men?

What are the racial predilections of hypogonadism?

How does the prevalence of hypogonadism vary by sex?

How does the prevalence of hypogonadism vary by age?

What is the morbidity of hypogonadism?

What is the prognosis of hypogonadism?

How are females with Turner syndrome affected by hypogonadism?

Where are patient education resources for hypogonadism found?

Presentation

What is the focus of history for suspected hypogonadism?

What pubertal history is characteristic of hypogonadism?

What general patient history information is needed for the evaluation of hypogonadism?

What are the male-specific signs of hypogonadism?

What should be the focus of postpubertal history in the evaluation of hypogonadism in men?

Which causes of acquired testicular failure should be considered in the evaluation of hypogonadism?

What are female-specific signs of hypogonadism?

What does the presence of congenital anomalies and dysmorphic features indicate in the evaluation for hypogonadism?

Which physical findings of the testes are characteristic of hypogonadism in males?

Which physical findings of the genitalia are characteristic of hypogonadism in males?

Which etiologies are suggested by the presence of microphallus in hypogonadism?

How is puberty staged in the evaluation of hypogonadism?

Which findings suggest a diagnosis of Klinefelter syndrome in the evaluation of hypogonadism?

What is included in an exam of female genitalia in suspected hypogonadism?

How is the extent of estrogenization determined in the evaluation of hypogonadism in females?

What are signs of Turner syndrome in females with hypogonadism?

What are common causes of hypogonadism?

What are the CNS causes of hypogonadotropic hypogonadism?

What are the genetic causes of hypogonadotropic hypogonadism?

What are congenital disorders associated with hypogonadotropic hypogonadism?

What are acquired disorders associated with hypogonadotropic hypogonadism?

What are the causes of hypergonadotropic hypogonadism in males?

What are the causes of hypergonadotropic hypogonadism in females?

What is the role of genetics in the etiology of hypogonadotropic hypogonadism?

DDX

How is hypogonadism differentiated from constitutional delay of puberty?

How are hypogonadotropic and hypergonadotropic hypogonadism differentiated?

What makes differentiating between hypogonadotropic hypogonadism and constitutional delay challenging?

What is the significance of anosmia and/or microphallus in the diagnosis of hypogonadism?

What are the diagnostic considerations for Turner syndrome in females with hypogonadism?

What are the diagnostic considerations for Klinefelter syndrome in males with hypogonadism?

What are the differential diagnoses for Hypogonadism?

Workup

What is the general approach to the evaluation of hypogonadism?

Which test is performed to distinguish between hypogonadotropic and hypergonadotropic hypogonadism?

What is the role of hormone testing in the evaluation of hypogonadism?

What should be including in the initial evaluation of hypogonadism in the absence of specific symptoms or signs?

How is hypogonadism diagnosed in males after puberty?

What is the role of testosterone testing in the diagnosis of hypogonadism in males?

How does obesity affect lab study results in men with hypogonadism?

Which tests may be helpful in the evaluation of men with hypogonadism?

What is the role of karyotyping in the workup of females with hypogonadism?

Which lab studies should be performed in the evaluation of hypogonadism in females?

What is the role of brain MRI in the workup of hypogonadism?

What is the role of pelvis imaging in the workup of hypogonadism?

What is the role of bone age in the evaluation of adolescents with hypogonadism?

What is the role of adrenocorticotropic hormone (ACTH) stimulation testing in the workup of hypogonadism?

What is the role of luteinizing-hormone releasing hormone (LHRH) stimulation testing in the workup of hypogonadism?

What is the role of testicular tissue testing in the workup of hypogonadism?

What is the role of testosterone priming in the management of hypogonadism?

What is the role of progestin in the evaluation of females with hypogonadism?

What is the role of testicular biopsy in the workup of hypogonadism?

Treatment

What are the goals of sex steroid replacement in the treatment of hypogonadism?

What are the options for fertility inducement in the treatment of hypogonadism?

What is the efficacy of sex steroid replacement in the treatment of hypogonadism?

What is the focus of treatment for hypogonadism in prepubertal patients?

How are sex steroids used in the treatment of hypogonadism in females?

How is testosterone used in the treatment of hypogonadism in males?

How are male patients treated for hypogonadism when fertility is desired?

What is the efficacy of combined corifollitropin-alfa and hCG in the treatment of hypogonadism?

How is testosterone administered in the treatment of hypogonadism?

What are the treatment options for older men with testosterone deficiency and hypogonadism?

How safe is testosterone replacement therapy for the treatment of male hypogonadism?

What are the benefits of testosterone therapy for men with hypogonadism?

What is the role of surgery in the treatment of hypogonadism?

Which specialist consultations are beneficial for patients with hypogonadism seeking fertility?

Which specialist consultations are beneficial for patients with Klinefelter syndrome and hypogonadism?

What are the complications of hypogonadism in males?

What are the complications of hypogonadism in females?

How is the risk for osteoporosis managed in hypogonadism?

What is included in long-term monitoring of patients with hypogonadism?

How is the risk for polycythemia managed in hypogonadism?

Medications

Which medications are used in the treatment of hypergonadotropic hypogonadism?

Which medications are used in the treatment of hypogonadotropic hypogonadism?

What are the limitations of sex steroid replacement in the treatment of hypogonadism?

What is the role of oral contraceptives in the treatment of hypogonadism?

Which medications in the drug class Progesterone agents are used in the treatment of Hypogonadism?

Which medications in the drug class Estrogen agents are used in the treatment of Hypogonadism?

Which medications in the drug class Testosterone agents are used in the treatment of Hypogonadism?