[Disorders of gonadal function in hypothalamic-pituitary diseases].
Hypothalmic-pituitary-gonadal hormones are regulated by number of factors including GnRH, LH and FSH, and gonadal hormones. They are regulated also by pituitary prolactin, activin and inhibin. Hypogonadism is divided into primary and secondary hypogonadism. Secondary hypogonadism is caused by various lesions involving either the hypothalmus or the pituitary. In this paper, etiology, diagnosis and treatment of the secondary hypogonadism are described. The most frequent causes of hypothamic hypogonadism are hypothalamic tumors, such as germinoma. As the pituitary hypogonadism, pituitary tumors, and Sheehan's syndrome are most common disorders. Diagnosis of the secondary hypogonadism is made based on the diagnostic criteria established by The Research Group of the Japanese Ministry of Health and Welfare. The criteria includes signs and symptoms in addition to laboratory examinations such as measurement of serum gonadotropin, sex steroid and LH-RH test. First choice of the treatment of hyothalmic hypogondism is continuous pulsatile injection of synthetic LH-RH. In the pituitary hypogonadism, hCG, hMG, estrogen and testosterone or the combination of these are applied depending upon the age and other factors of the patients.
Tanaka
K
K
Third Department of Medicine, Teikyo University School of Medicine.
Toriumi
M
M
Shinohara
Y
Y
Okazaki
R
R
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy / Q000209:etiology*; D007027:Hypothalamic Diseases / Q000150:complications*; D008297:Male; D010900:Pituitary Diseases / Q000150:complications*