MALE HYPOGONADISM AT A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN
Abstract
Background: Male hypogonadism is defined as '˜inadequate gonadal function, manifested bydeficiency in gametogenesis and/or secretion of gonadal hormones'. Signs and symptoms of
hypogonadism depend primarily on the age of onset. It can be classified according to the site
primarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this study
was to determine the presentation and aetiology of male hypogonadism seen in a tertiary care
hospital. Methods: This cross-sectional study was conducted at Endocrine Clinics, Aga Khan
University Hospital Karachi. Data of male patients with hypogonadism who attended clinics
during January 2009 to August 2011 were reviewed. All male patients with clinical and
biochemical evidence of hypogonadism were included in the study. Patients with Diabetes
Mellitus, Metabolic Syndrome, Andropause, AIDS, Chronic Renal Failure, and Cirrhosis were
excluded. Mean±SD were computed for quantitative variables. Frequency and percentages were
computed for qualitative variables. Aetiology of male hypogonadism was categorised as primary
and secondary hypogonadism. Results: A total of 85 patients with male hypogonadism attended
the endocrine clinic. Mean age of patients was 25±10 years. Clinical presentations were small
genitalia (65%), absent secondary sexual characteristics (53%), not attained puberty (47%),
infertility (53%), erectile dysfunction (41%) and loss of libido (29%). Seventy-three (86%)
patients had hypogonadotrophic hypogonadism (secondary hypogonadism) and 12 (14%) patients
had hypergonadotrophic hypogonadism (primary hypogonadism). Among the patients with
hypogonadotrophic hypogonadism 38 had idiopathic hypogonadotrophic hypogonadsim, 7 had
pituitary adenoma, 6 had empty sella syndrome, 3 had Kallman's syndrome, and 1 patient had
haemosiderosis due to thalassaemia major; 18 patients did not undergo brain imaging.
Conclusion: Small genitalia, absent secondary sexual characteristics and infertility were the main
presenting features of hypogonad men. Majority of patients had hypogonadotrophic
hypogonadsim.
Keywords: Male Hypogonadism, Erectile dysfunction, Libido, Infertility
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