FAQ – Hypogonadism – MEDICAL DIAGNOSIS AND MEDICINAL PLANTS

Recommended by Dr. Michael White, Updated on January 5th, 2018

Hypogonadism? I have been checked and found out to be low in progesterone. I have taken profasi and pregnyl injections last month still no luck. Been trying to get pregnant for two years now,was on clomid from nov 2005-oct 2006,stopped when taking injections. When should i go for check up to check if the injections increased my progesterone level? Thanks for your anticipated assistance.

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For women who have not had their uterus removed, combination treatment with estrogen and progesterone is often recommended to decrease the chances of developing endometrial cancer. In addition, low dose testosterone can be added for hypogonadal women with a low sex drive.

If there is a correctible cause of hypogonadism (e.g., a pituitary tumor), medication may be given (particularly for prolactinoma) or surgery and/or radiation therapy may be required. Injections or oral medication can be used to stimulate ovulation. Injections of pituitary hormones may be needed for men with hypogonadism to produce sperm. Therapy may also target nutritional, infectious, or other causes of the problem. http://www.nlm.nih.gov/medlineplus/ency/article/001195.htm#Treatment

Hypogonadism is most often treated by replacement of the appropriate hormones. For men this is testosterone. For women estradiol and progesterone are replaced. Some types of fertility defects can be treated; some cannot. http://en.wikipedia.org/wiki/Hypogonadism#Treatment

Medical Care: In prepubertal patients, treatment is directed at initiating pubertal development at the appropriate age. All such treatment is hormonal replacement therapy. Although the simplest and most successful treatment for both males and females with either hypergonadotropic or hypogonadotrophic hypogonadism is replacement of sex steroids, in hypogonadotropic hypogonadism, the therapy does not confer fertility or, in men, stimulate testicular growth.

An alternative for men with hypogonadotropic hypogonadism has been treatment with pulsatile LHRH or hCG, either of which can stimulate testicular growth. Since such treatment is more complex than testosterone replacement, and since treatment with testosterone does not interfere with later therapy to induce fertility, most male patients with hypogonadotropic hypogonadism prefer to initiate and maintain virilization with testosterone. At a time when fertility is desired, it may be induced with either pulsatile LHRH or (more commonly) with a schedule of injections of hCG and FSH. In patients with hypergonadotropic hypogonadism, fertility is not possible. Surgical Care: The only issue of surgical relevance is whether gonadal tissue should be removed.

As a result of the significant risk of gonadoblastoma and carcinoma, gonadal tissue should be removed in females with karyotypes containing a Y chromosome. This situation exists in a female with XY gonadal dysgenesis or in a patient with Turner syndrome who has a karyotype containing a Y chromosome (usually in 1 of 2 or more mosaic karyotypes). Males with nonfunctioning testicular tissue should undergo orchiectomy and replacement with prostheses. Consultations: Consultation with a reproductive endocrinologist is required for patients who would like to become fertile. Administration of pulsatile LHRH in adolescents before fertility is desired carries no benefit.

Treatment of patients with hypergonadotropic hypogonadism involves replacement of sex steroids in both males and females.

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FAQ - Hypogonadism - MEDICAL DIAGNOSIS AND MEDICINAL PLANTS

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