Male Hypogonadism: A Case Study

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Testosterone is produced in the testes and helps maintain a man’s sex drive, sperm production, facial, pubic, and body hair, muscles and bones. Male hypogonadism is characterized by low circulating testosterone levels two types of hypogonadism exist depending on the origin of the deficit among the organs necessary to maintain the hypothalamic- pituitary- gonadal feedback (Sargis). Primary hypogonadism is characterized by testicular failure which can be caused by injury to the testes, undescended testicles, or genetic disorders such as Klinefelter syndrome. Secondary hypogonadism is characterized by problems with either the hypothalamus or pituitary gland which can be caused by aging, pituitary disorders, medications like opioids, and type 2 …show more content…
He was prescribed transdermal fentanyl for chronic pain after traffic injury. In this case, the patient complained of general fatigue and erectile dysfunction. His tests showed low LH, FSH, total testosterone, and free testosterone. Opioid-induced endocrine dysfunctions were first reported in 1973 and since then several studies have been done linking various opioid use to hypogonadism (Tabuchi, et al.). Another case I studied was a general study done about Klinefelter Syndrome (KS, 47, XXY), a primary form of hypogonadism. Klinefelter Syndrome, a genetic disorder, affects 1 in 600 men but the diagnosis is not guaranteed because it has variable expressivity. Across most men with KS phenotypically are infertile and have testicular dysfunction. The extra X chromosome impacts the body which leads to a variety of symptoms such as hypogonadism, azoospermia, varying degree of learning disabilities and psychological problems. Men with KS lack facial, body and pubic hair, small testes, wide hips, narrow shoulders, and an in breast development (Host, et …show more content…
Low testosterone is characterized by decreased sex drive, erectile dysfunction, enlarged breasts, and low sperm count. Severe low testosterone causes more complex issues such as loss of body hair, loss of muscle, weakened bones, mood swings, depression, and hot flashes. A variety of symptoms are found in KS patients, but for the opioid-induced patient his symptoms matched that of low testosterone. Though no known cures for men with KS-induced hypogonadism, the disease phenotypes can be managed using testosterone replacement therapy (Host, et al.). Generally, for opioid-induced hypogonadism would be treated by stopping the medication and changing to a non-opioid medication or to an opioid agonist such as buprenorphine, that slows pain signal integration without the side effects of opiates. In this case, changing the medication was not an option due to the patient’s pain level so, testosterone replacement therapy was done (Tabuchi, et al.). Testosterone replacement can be done via gels, patches, tablets, or injections. The treatment is not a cure for hypogonadism, but can help improve quality of life by helping elevate the patient’s mood, sex drive, and help improve muscle and bone strength. Replacement therapy, however, has a risk of causing prostate cancer in men
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