Ch 81 Male Reproductive Diseases

male climacteric (andropause)

- Testosterone in aging: decrease slowly after age 40 - andropause ? o dec. bone formation, muscle mass, o dec. growth of facial hair, appetite, o dec. libido o LH not changed; FSH increased with aging in men o loss of sexual activity -about 68-70 yrs of age - Testosterone supplements: osteoporosis, libido, performance

Propecia (finasteride)

Antagonizes one of the enzymes (5 α-reductase) which converts testosterone to DHT(the active metabolite which adversely affects hair follicles.

Rogaine (minoxidil)

Don't know how it works No one seems to care

Cryptorchidism

Failure of one of the testicles to descend Descent dependent on testosterone Administration of testosterone or gonadotropin hormones typically trigger descent. Can lead to sterility (possibly) if not treated. Often indicates underlying deficiency in testes production of testosterone.

Eunuchs

In the absence of testosterone in utero, female genitalia will form. Castration prior to puberty leads to eunachism. Similar to primary hypogonaidism. Castration after puberty leads to partial regression of sex characteristics.

Erectile Dysfunction

Multiple Causes Psychosomatic Neurological Hormonal Drug related Ageing related vascular disease Hypertension, diabetes, athrosclerosis Ultimately all the same final cause: lack of adequate blood flow to the erectile tissue in the penis, due to decreased NO-mediated vasodilation.

Hypogonadism

Naturally caused by genetic inability to produce GnRH. This form concurrent with hypothalamic dysfunction, causing hyperphagia. Normal puberty absent, primary and secondary sex traits absent.

Hypergonadism

Overproduction of androgens. Typically caused by tumors, usually benign. Leydig cell tumors create most testosterone Germinal teratomas are much more common and vary in production of testosterone. Symptoms depend on time of development.

ED Rx

PDE5 inhibitors Viagrea Levitra Cialis

male pattern baldness

Testosterone-a little is good, a lot is dangerous. Testosterone linked in combination with genetic predisposition. 5 α-reductase at the vertex of the head? Can see "male" pattern baldness in women with androgenic tumors.