MALE HYPOGONADISM AT A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN
AbstractBackground: Male hypogonadism is defined as ‘inadequate gonadal function, manifested bydeficiency in gametogenesis and/or secretion of gonadal hormones’. Signs and symptoms ofhypogonadism depend primarily on the age of onset. It can be classified according to the siteprimarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this studywas to determine the presentation and aetiology of male hypogonadism seen in a tertiary carehospital. Methods: This cross-sectional study was conducted at Endocrine Clinics, Aga KhanUniversity Hospital Karachi. Data of male patients with hypogonadism who attended clinicsduring January 2009 to August 2011 were reviewed. All male patients with clinical andbiochemical evidence of hypogonadism were included in the study. Patients with DiabetesMellitus, Metabolic Syndrome, Andropause, AIDS, Chronic Renal Failure, and Cirrhosis wereexcluded. Mean±SD were computed for quantitative variables. Frequency and percentages werecomputed for qualitative variables. Aetiology of male hypogonadism was categorised as primaryand secondary hypogonadism. Results: A total of 85 patients with male hypogonadism attendedthe endocrine clinic. Mean age of patients was 25±10 years. Clinical presentations were smallgenitalia (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%) patientshad hypergonadotrophic hypogonadism (primary hypogonadism). Among the patients withhypogonadotrophic hypogonadism 38 had idiopathic hypogonadotrophic hypogonadsim, 7 hadpituitary adenoma, 6 had empty sella syndrome, 3 had Kallman’s syndrome, and 1 patient hadhaemosiderosis due to thalassaemia major; 18 patients did not undergo brain imaging.Conclusion: Small genitalia, absent secondary sexual characteristics and infertility were the mainpresenting features of hypogonad men. Majority of patients had hypogonadotrophichypogonadsim.Keywords: Male Hypogonadism, Erectile dysfunction, Libido, Infertility
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