Hereditary and Metabolic Diseases of the Central Nervous System in Adults
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Adrenomyeloneuropathy (AMN): 40–45% cases: Onset mid-20s to middle age.Slowly progressive spastic paraparesis without upper limb involvement.Impaired vibration and position sense.Urinary and sexual dysfunction.Mild peripheral nerve involvement: slowing of sensory and motor conduction velocities.Hypogonadism is common.Mild cognitive decline.Adrenal insufficiency can occur after onset of paraparesis.
The minerals
Geoffrey P. Webb in Nutrition, 2019
The accelerated bone loss associated with menopausal oestrogen loss suggests that anything that diminishes sex hormone output might be likely to increase bone loss and fracture risk. Conditions in which there is reduced sex hormone output are indeed associated with reduced bone density (see the following list). Early menopause or surgical removal of the ovaries. Cessation of menstruation due to starvation or Anorexia Nervosa. Amenorrhoea due to extremely high activity and low body fat content in women athletes. Hypogonadism in men.
Genetic Causes of Male Infertility
Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh in Male Infertility in Reproductive Medicine, 2019
Impairment of gonadotropin secretion may result from decreased gonadotropin-releasing hormone (GnRH) production, which leads to quantitative decrease in spermatogenesis. Hypogonadotropic hypogonadism can occur due to congenital or acquired causes. Monogenetic mutations account for around 50% of cases and contribute to CHH via several modes of inheritance, including monogenic autosomal or X-linked (dominant or recessive forms) and oligogenic [51]. Genetic mutations involving FGFR1, FGF8, and SOX10 disrupt embryonic development of GnRH neurons, whereas ANOS1 (formally KAL1), PROK2, PROK2R, and CHD7 impair migration of GnRH neurons from the olfactory placode to the hypothalamus. Other mutations that are associated with GnRH neuron dysregulation involve TAC3, TACR3, KISS1, KISS1R, and OTUD4 genes. Additionally, mutations of GnRH1 gene and its receptor (GnRHR) manifest with CHH [52]. In addition to hypogonadism, certain phenotypic features may be associated with some of the genetic causes of CHH, including anosmia (Kallmann syndrome), cryptorchidism, micro-penis, cleft lip or palate, and renal agenesis [51].
Testosterone treatment and change of categories of the International prostate symptom score (IPSS) in hypogonadal patients: 12 years prospective controlled registry study
Published in The Aging Male, 2023
Aksam Yassin, Daniel Kelly, Joanne Nettleship, Raidh Talib, Raed M. Al-Zoubi, Omar M. Aboumarzouk, Bassam Albaba
Functional hypogonadism is a condition characterized by low serum testosterone concentrations and symptoms in males, a condition that becomes increasingly prevalent as men age [1]. Approximately 20% of men over the age of 60 have low testosterone levels, rising to 30% over the age of 70 and 50% over the age of 80 [2]. The clinical features of functional hypogonadism include absence or regression of secondary sex characteristics, insulin resistance or type 2 diabetes (T2D), hypertension, dyslipidemia, anemia, muscle atrophy, reduced bone mass or bone mineral density, oligospermia, decreased libido, decreased sexual function and abdominal adiposity [3]. Along with T2D, other co-morbidities potentially caused by low testosterone include metabolic syndrome (MetS) and obesity, all of which are associated with increased age [4]. These co-morbidities often exacerbate the effects of hypogonadism, significantly reducing the quality of life (QoL) for patients and ultimately increasing mortality [3,4].
How can we mitigate treatment-associated morbidity in patients with germ cell tumors?
Published in Expert Review of Anticancer Therapy, 2021
Raj R. Bhanvadia, Fady J. Baky, John T. Lafin, Aditya Bagrodia
Radical orchiectomy is the first step in diagnosis, treatment, and prognostication in nearly all patients with GCT. There are an array of psychologic and physiologic concerns pre- and post-orchiectomy. Up to a third of men feel a sense of loss and shame after orchiectomy, and 10% may experience hypogonadism [3,4]. All patients should have a discussion of the risks and benefits of a testicular prosthesis, which has generally been associated with improved patient satisfaction, though a percentage of men (10–25%) have concerns about location, size, and interference with sexual function and physical activity [5,6]. While the overall incidence of clinical hypogonadism is low, monitoring for symptoms of hypogonadism with a history and physical exam is simple, cost effective, and allows workup and initiation of testosterone if indicated. In the approximately 2% of patients who develop second testicular primaries, androgen supplementation is requisite and should be coordinated at the time of orchiectomy. Nearly half of men have defects in spermatogenesis at the time of diagnosis, an important quality of life issue in the majority of young men diagnosed with GCT. Patients should be reassured that paternity rates exceed 90% after orchiectomy alone, but abnormalities in semen parameters should warrant discussion regarding further workup and cryopreservation should be discussed with all patients [7].
The severity of hypogonadism symptoms and its risk factors among male employees of Tehran University of Medical Sciences
Published in The Aging Male, 2020
Elahe Afsharnia, Minoo Pakgohar, Hamid Haghani, Asma Sarani, Shahla Khosravi
Various studies have been conducted with respect to the risk factors of hypogonadism. Only the impact of few of these factors has been recognized, and most of these factors still have room for debate. In this regard, some studies have addressed the impact of factors such as age, BMI, cigarette consumption, educational status, employment, income, marital status, diabetes, and signs of hypogonadism [1,33–37]. Despite the aforementioned studies, there are still many doubts regarding the impact of each of these personal traits on hypogonadism. Given the problems threatening male health, the risk factors must be identified and dealt with to neutralize their effects. By detecting these factors, and through preventive measures, males can be safeguarded against the possible complications of this phenomenon [38] and also reduce its associated healthcare costs. For example, many individuals with hypogonadism who have multiple associated diseases, increased waist circumference and obesity can benefit from lifestyle changes such as weight reduction as well as testosterone replacement therapy (TRT) [39]. Multiple studies have indicated that the injection of testosterone undecanoate has led to a significant reduction in waist circumference and visceral fat, and has been introduced as an appropriate treatment of hypogonadism [40]. Bearing in mind the significance of hypogonadism, the scarcity of data in this field in Iran, and the conflicting information present in earlier literature, we sought to estimate the prevalence of hypogonadism and its determinant factors in males employed at Tehran University of Medical Sciences (TUMS).
Related Knowledge Centers
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- Ovary
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- Androgen
- Testicle
- Sex Hormone
- Estradiol