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Embryology, Anatomy, and Physiology of the Male Reproductive System
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Testosterone is a steroid hormone.Supports spermatogenesis by binding the androgen receptor of Sertoli cells.Responsible for the development of male secondary sexual characteristics.In an adult male: normal levels >12 nmol/L, equivocal 8−12 nmol/L, low <8 nmol/L.~60% bound to sex hormone-binding globulin (SHBG)~38% bound to albumin (bioavailable)~2% free (bioavailable)
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Cryptomenorrhoea in a 15-year-old girl is associated with:Short stature.Absence of secondary sexual characteristics.Chromosomal abnormality.Atresia of the Miillerian ducts.Imperforate hymen.
Summation of Basic Endocrine Data
Published in George H. Gass, Harold M. Kaplan, Handbook of Endocrinology, 2020
Testosterone develops and maintains male secondary sexual characteristics that have been markedly activated at the time of puberty. Even in the fetus, the hormone has already initiated differentiation of the male phenotype.
Considerations when treating male pubertal delay pharmacologically
Published in Expert Opinion on Pharmacotherapy, 2022
Testosterone replacement therapy has been used for decades to induce secondary sexual characteristics and pubertal growth spurt in male teenagers with delayed puberty for short periods in patients with CDGP and as a permanent treatment in those with primary or central hypogonadism. The longstanding experience indicates that low-dose starting treatments with progressive scaling to attain serum testosterone levels in the adult range within 2–3 years are safe and efficacious. Aromatase inhibitors have arisen as an alternative to induce pubertal androgenisation while preserving the growth cartilage at the epiphyseal plate, thus specially interesting when short stature is a concern. Finally, pulsatile GnRH treatment using special pumps and gonadotrophin replacement therapies, starting with FSH and subsequently adding hCG or LH, are needed to induce spermatogenesis in patients with central hypogonadism. These treatments have only been used under research protocols. Whether these complex regimens should be used to induce pubertal changes, or only later in adulthood when fertility is sought, is still matter of debate.
What are the pharmacological considerations for male congenital hypogonadotropic hypogonadism?
Published in Expert Opinion on Pharmacotherapy, 2022
Giulia Rastrelli, Mario Maggi, Giovanni Corona
The objective of the treatment in CHH patients depends on patient’s age and requests. In adolescence, the main aim of the treatment is to induce the development of secondary sexual characteristics. In young adults with a fertility wish, spermatogenesis is the pivotal aim. Lastly, in middle-aged/elderly men, fertility loses its primary importance and sexual function, muscle strength, and body composition are the most important outcomes. It is also important to mention that, when red flags are identified in neonates or infants and CHH is suspected and/or diagnosed early in life, a short course treatment (3–6 months) with gonadotropins or GnRH may be attempted to induce testicular descent and development as well as to improve penile length [4]. However, there is still no consensus on this early treatment mainly due to a limited amount of data on the topic that have been recently reviewed [4].
The evaluation of ovarian function in normosmic idiopathic hypogonadotropic hypogonadism with a fibroblast growth factor receptor 1 mutation: a case report
Published in Gynecological Endocrinology, 2022
IHH patients with different clinical manifestations often visit varieties of clinics (endocrinology, pediatrics, neurosurgery, urology, obstetrics, and gynecology). Besides, if IHH can be recognized in the early stage, the prognosis might be better [8]. Therefore, it is critical for long-term follow-up visits and the systematic management of the disease after a correct initial diagnosis and subsequent referrals. To minimize the physiology and psychological effects associated with IHH, timely treatment to induce puberty can be also crucial [1]. Estrogen combined with progesterone replacement alone can reverse the problems associated with hypogonadism and is considerably much cheaper than other available options [9]. In this case, HT promoted the development of secondary sexual characteristics.