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Pituitary Dysfunction Among Men Presenting with Hypogonadism

  • Men’s Health (A Dabaja, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Hypogonadism is a common endocrine dysfunction. This review focuses on the most up-to-date guideline for evaluation of pituitary function among men presenting with signs and symptoms of hypogonadism.

Recent Findings

The clinician must differentiate between primary (testicular) and secondary (pituitary-hypothalamic or central) hypogonadisms and be aware of adult-onset hypogonadism. If gonadotropins are low or inappropriately normal, the clinician must consider potential reversible causes in the hypothalamus-pituitary axis. Also, it is critical to understand the pitfalls of testosterone testing. When clinically indicated, evaluation of other pituitary hormone functions as well as pituitary magnetic resonance imaging may be necessary. Furthermore, it is essential to recognize that pituitary incidentalomas are common. Patients with microprolactinoma are more likely to present with symptoms of sexual dysfunction while those with macroprolactinoma are more likely to present with symptoms of mass effect. Some functional pituitary tumors respond to drug therapy while other nonfunctional tumors require surgical intervention.

Summary

It is important for the clinician to understand the proper work-up of the hypogonadal patient with pituitary dysfunction and when necessary to refer to an endocrinologist or a neurosurgeon.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes, and Bone & Mineral Disorder, Henry Ford Medical Center--New Center One, 3031 W. Grand Blvd, Detroit, MI, 48202, USA

    Shiri Levy, Mingxue Arguello & Sudhaker D. Rao

  2. Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA

    Mohamed Macki

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  1. Shiri Levy
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  2. Mingxue Arguello
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Correspondence to Shiri Levy.

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Shiri Levy, Mingxue Arguello, Mohamed Macki, and Sudhaker D. Rao each declare no conflict of interest.

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This article does not contain any studies with unethical treatment of human or animal subjects.

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Levy, S., Arguello, M., Macki, M. et al. Pituitary Dysfunction Among Men Presenting with Hypogonadism. Curr Urol Rep 20, 78 (2019). https://doi.org/10.1007/s11934-019-0935-z

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  • DOI: https://doi.org/10.1007/s11934-019-0935-z

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