Pediatric Hypogonadism

Pediatric Hypogonadism

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Summary

Hypogonadism or gonad deficiency occurs when the sex glands produce little or no sex hormones. Sex glands or gonads are ovaries in girls and testes in boys. 

Types

Primary hypogonadism is when there not enough sex hormones are produced in body. The message from the brain to the gonads is received but they are not able to produce them. 

Causes

  • Autoimmune disorders such as Addison's disease
  • Certain disorders where the body mistakenly attacks healthy tissue
  • Genetic and developmental disorders
  • Infection
  • Liver and kidney disease
  • Radiation exposure
  • Surgery on sex organs
  • Undescended testes (UDT)

Secondary or central hypogonadism occurs when there is a problem with the pituitary gland in the brain and the messages to produce the hormone aren’t working.

Causes

  • Bleeding
  • Certain medicines, including steroids and opiates
  • Genetic problems
  • Infections such as HIV and AIDS
  • Inflammatory diseases such as sarcoidosis, tuberculosis and histiocytosis
  • Nutritional deficiencies
  • Obesity
  • Radiation exposure
  • Rapid, significant weight loss
  • Surgery
  • Trauma
  • Tumor in or near the pituitary gland

Symptoms in girls

In girls, hypogonadism will affect breast development and height. There may be a delay in beginning menstruation.  If hypogonadism occurs after puberty, symptoms include:

  • Hot flashes
  • Loss of body hair
  • Cessation of menstruation
  • Milky discharge from breasts

Treatment

Hormone replacement is also widely prescribed for girls with hypogonadism. Estrogen and progesterone are usually given together.

Symptoms in boys

In boys, hypogonadism will most often be manifested as less than normal muscle development, very little or no facial hair and growth problems. After puberty, symptoms include:

  • Breast enlargement
  • Decreased facial and body hair
  • Difficulty concentrating
  • Infertility
  • Fatigue
  • Hot flashes
  • Muscle loss
  • Sexual problems

Treatment

For boys with hypogonadism, testosterone replacement therapy can trigger puberty and start the development of increased muscle mass, facial and pubic hair and growth of the penis. Pituitary hormones may be prescribed to stimulate testicular growth.

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