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Low testosterone can be identified through a simple blood test performed by a laboratory, ordered by a health care provider. Blood for the test must be taken in the morning hours, when levels are highest, as levels can drop by as much as 13% during the day and all normal reference ranges are based on morning levels. [9] [10]
The underlying cause is due to the defective migration of GNRH neurons from olfactory placode to hypothalamus, leading to congenital GNRH deficiency. This leads to olfactory problems such as anosmia, optic defects like color blindness, and results in hypothalmic deficiencies associated with low levels of LH, affecting sex hormone testosterone in males or estrogen and progesterone in females.
Levels of LH/FSH may be suppressed by a raised prolactin level, and are therefore not interpretable unless prolactin is low or normal. In men, the combination of low LH and FSH in combination with a low testosterone confirms LH/FSH deficiency; a high testosterone would indicate a source elsewhere in the body (such as a testosterone-secreting ...
Hypergonadotropic hypogonadism (HH), also known as primary or peripheral/gonadal hypogonadism or primary gonadal failure, is a condition which is characterized by hypogonadism which is due to an impaired response of the gonads to the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and in turn a lack of sex steroid production. [1]
Follicle-stimulating hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone. [1] FSH is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland [ 2 ] and regulates the development, growth, pubertal maturation , and reproductive processes of the body.
In the female, the goal for gonadotropin therapy is to obtain ovulation. This is obtained with FSH treatment followed by hCG or LH to trigger ovulation. FSH will stimulate granulosa cells for follicular maturation while LH will act on luteal cells to produce steroids aiding follicular maturation and preparing the endometrium for pregnancy.
The prostate, like the external male genitalia, cannot masculinize in the absence of androgen receptor function, and thus remains in the female form. [18] [36] [37] [38] The Müllerian system typically regresses the same way it does in unaffected male fetuses due to anti-Müllerian hormone originating from the Sertoli cells of the testes. [19]
Administration of luteinizing hormone (LH) (or human chorionic gonadotropin) and follicle-stimulating hormone (FSH) is very effective in the treatment of male infertility due to hypogonadotropic hypogonadism. [58] Although controversial, [59] off-label clomiphene citrate, an antiestrogen, may also be effective by elevating gonadotropin levels. [58]
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