Aetiology
There are four aetiological classes of hypogonadism in the male (1,2):
- primary hypogonadism - i.e. hypogonadism due to testicular failure
- congenital primary gonadal disease
- acquired primary gonadal disease
- secondary hypogonadism - may be due to reduced gonadotrophins due to hypothalamic-pituitary disease
- congenital e.g. Kallman's syndrome
- secondary e.g. pituitary tumours
- reversible secondary hypogonadism may also be the result of systemic illness e.g. (end-stage respiratory or renal disease), obesity, hyperprolactinaemia, long-term excessive exercise (1), poor nutritional status, supra-physiological doses of steroids, drugs (spironolactone, ketoconazole, marijuana)
References:
- Salonia A, Rastrelli G, Hackett G, et al. Paediatric and adult-onset male hypogonadism. Nat Rev Dis Primers. 2019 May 30;5(1):38.
- Matsumoto AM. Diagnosis and evaluation of hypogonadism. Endocrinol Metab Clin North Am. 2022 Mar;51(1):47-62.
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