Treatment of male hypogonadism (m)
Treatment of male hypogonadism
The problem of hypogonadism and male infertility can be treated at all three levels of the hypothalamic-pituitary-testis axis depending on the localization of the disorder. The following hormone supplements are used:
- LHRH agonists such as gonadorelin or goserelin mimic the action of LHRH when administered in a pulsatile manner. These agents are used to treat hypogonadism with hypothalamic dysfunction.
- Gonadotropins such as human chorionic gonadotropin (hCG) and follitropin (FSH) are used to treat secondary hypogonadism. The goal of this treatment is to increase fertility by stimulating de development of germ cells.
- Androgens such as testosterone are used in cases of primary hypogonadism and hypopituitarism. The aim of this treatment is to induce secondary sex characteristics. Androgen treatment has no positive effects on fertility.
A male patient who has undergone a pituitary adenectomy has now developed hypogonadism. Which therapy would be suitable for the patient in order to restore effective spermatogenesis?
Extra info: Supplying testosterone is necessary. Virtually all patients who need T replacement for hypopituitarism rarely have spontaneous, effective spermatogenesis. Both GnRH by subcutaneous pump and gonadotropins by daily subcutaneous injections have been used effectively to induce fertility.