Hypogonadotropic means containing low levels of gonadotropins. Gonadotropins are hormones from the brain that control the secretion of sex hormones.
Clomiphene citrate, often referred to as Clostil, can be effective in treating male infertility, particularly in cases of hypogonadotropic hypogonadism or low testosterone levels. It works by stimulating the hypothalamus and pituitary gland to increase the production of hormones that promote sperm production. However, its effectiveness varies among individuals, and it is essential for men to consult a healthcare professional for a proper diagnosis and personalized treatment plan.
Anorexia nervosa (AN) is a psychiatric disease associated with notable medical complications and increased mortality. Endocrine abnormalities, including hypogonadotropic hypogonadism, hypercortisolemia, growth hormone resistance and sick euthyroid syndrome, mediate the clinical manifestations of this disease. Alterations in anorexigenic and orexigenic appetite-regulating pathways have also been described. Decreases in fat mass result in adipokine abnormalities. Although most of the endocrine changes that occur in AN represent physiologic adaptation to starvation, some persist after recovery and might contribute to susceptibility to AN recurrence. In this Review, we summarize key endocrine alterations in AN, with a particular focus on the profound bone loss that can occur in this disease. Although AN is increasingly prevalent among boys and men, the disorder predominantly affects girls and women who are, therefore, the focus of this Review.
DefinitionHypogonadotropic hypogonadism is absent or decreased function of the male testes or the female ovaries. It is considered a form of secondary hypogonadism, which means the condition is due to a problem with the pituitary or hypothalamus gland.See also: HypogonadismAlternative NamesGonadotropin deficiency; Secondary hypogonadism; Kallmann syndromeCauses, incidence, and risk factorsHypogonadotropic hypogonadism is caused by a lack of the gonadal stimulating pituitary hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH).Normally, the hypothalamus in the brain releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release other hormones, including FSH and LH. These hormones tell the female ovaries and male testes to secrete hormones that are responsible for normal sexual development in puberty. A disruption in this chain of events causes a deficiency of the sex hormones and prevents normal sexual maturity.Failure of the hypothalamus is most commonly a result of Kallmann syndrome. Kallmann syndrome is an inherited form of hypogonadotropic hypogonadism that can be associated with a loss of smell.SymptomsAbsence of secondary sexual characteristics such as pubic, facial, and underarm hairInability to smell (in some cases)Lack of development at puberty (may involve incomplete development or a significant delay in development)Underdeveloped testiclesShort stature(in some cases)Signs and testsTests that may be done include:Blood tests to measure various hormone levelsLH response to GnRHMRI of the headTreatmentTreatment depends on the source of the problem but may involve:Injections of testosteroneSlow-release testosterone skin patchEstrogen and progesterone pillsGnRH injectionsTestosterone gelsExpectations (prognosis)With the right hormone treatment, the person can begin puberty and fertility may be restored.ComplicationsDelayed pubertyInfertilityLow self-esteem due to late start of puberty (emotional support may be helpful)Calling your health care providerCall your health care provider if your child does not enter puberty as expected.PreventionPrevention depends on the cause. People who have a family history of inherited conditions associated with hypogonadism may benefit from genetic counseling. Preventing serious head injuries reduces the risk of pituitary injury-associated hypogonadotropic hypogonadism.ReferencesAACE Thyroid Task Force. AACE Hypogonadism Guidelines. Endocr Pract. 2002;8(6):441.Styne DM, Grumbach. Puberty: Ontogeny, neuroendocrinology, physiology, and disorders. In: Kronenberg HM, Shlomo M, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 24.