Gonadal function and dysfunction

Gonadal function and dysfunction Dr Thomas Fox Endocrine SpR Derriford Hospital

Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Testes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

Testosterone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Male Hypogonadism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Male hypogonadism with effects before and after puberty Normal body proportions Eunachoid stature Osteoporosis Delayed bone age Normal hair distribution but poor growth Decreased body and facial hair Central fat distribution Gynaecomastia Gynaecomastia Voice broken High pitched voice Normal penis length Penis <5cm Testes volume <145ml Testes volume <5ml After puberty Before puberty

Secondary hypogonadism ,[object Object],[object Object],[object Object]

Kallman’s syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Idiopathic hypogonadotrophic hypogonadism ,[object Object],[object Object],[object Object],[object Object],[object Object]

Miscellaneous causes of secondary hypogonadism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Primary hypogonadism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Opiates and hypogonadism ,[object Object],[object Object],[object Object],[object Object],[object Object]

Klinefelter’s syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Management ,[object Object],[object Object],[object Object],[object Object]

Noonan Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

XX males ,[object Object],[object Object],[object Object],[object Object]

Hypogonadism in the aging male ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Male androgens over time 60-70% testosterone bound to SHBG 30-40% testosterone bound to albumin

How to assess testosterone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Effects of testosterone replacement in the aging male

Effects of testosterone replacement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Risks of androgen replacement in the aging male ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

When to treat? ,[object Object],[object Object],[object Object],[object Object]

Testosterone replacement therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

hCG therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Human menopausal gonadotrophin therapy ,[object Object]

Summary ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object]

Gonadal function and dysfunction

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