Secondary Hypogonadism

Panhypopituitarism

Any process that prevents ACTH production will lead to adrenal hypofunction thus causing secondary adrenal insufficiency. This is similar then to Addison's disease, except that with Addison's disease the ACTH levels are high leading to skin hyperpigmentation. This is not the case with panhypopituitarism, as here ACTH is low.

Some of the causes for panhypopituitarism are : a pituitary gland tumor; a craniopharyngioma leading to a hypothalamus disorder (usually in childhood); Sheehan's syndrome in a woman who just delivered a baby with a difficult delivery and postpartum complications leading to pituitary dysfunction and a lack of lactation; prolonged corticosone treatment for various medical ailments (suppresses ACTH production).

Kallman Syndrome

This is an X-linked inherited condition where the person has no sense of smell due to a congenital absence of the olfactory lobes. Associated with this is a deficiency of hypothalamic GnRH (=gonadotropin releasing hormone), a microphallus instead of a normal genital organ (due to a lack of fetal GnRH) and cryptorchidism as well as a unilateral congenitally missing kidney. As it is X-linked, only the affected male is symptomatic as described above. Females can be carriers, but are symptom free.

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Hypogonadism

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

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4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 7:Pituitary disorders.

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12. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

13. J Bain: Can Fam Physician 2001 Jan;47:91-97.

Last Modified: Jan. 10, 2009