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Anatomy and Physiology of the Hypothalamic-Pituitary-Gonadal (HPG) Axis

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Advanced Practice in Endocrinology Nursing

Abstract

The hypothalamic-pituitary-gonadal (HPG) axis is central for human reproduction. This axis includes neuroendocrine networks that integrate wide ranging internal and external inputs to coordinate reproductive competence. Gonadotrophin-releasing hormone (GnRH) is the principal regulator of reproduction. GnRH controls gonadotrophin secretion and subsequently, gonadal (testicular) function. The HPG axis is activated during foetal life, neonatally and in puberty through adulthood. This developmental perspective is important as these periods contribute to the proper formation and development of sexual structures in utero as well as the development and function of the system enabling reproductive capacity in adulthood. The HPG axis remains silenced during childhood and neuroendocrine re-activation triggers pubertal onset. In early puberty, nocturnal sleep-entrained GnRH-induced gonadotrophin secretion stimulates testicular development and the initial rise in sex steroids resulting in the appearance of secondary sexual characteristics. Progressively, this pulsatile neuroendocrine activity extends through the day and is regulated by negative feedback. Puberty culminates in sexual maturation and the reproductive capacity of adult life. Sperm development occurs in the seminiferous tubules of the testes and requires testosterone and other testicular products for normal spermatogenesis. Effective HPG axis function is needed for normal sexual function and fertility and contributes to overall health and well-being. This chapter is a mini-review for endocrine nurses providing a summary of HPG axis development, function and regulation. This targeted summary is intended to serve as a basis for understanding key elements relating to male reproductive endocrine disorders such as hypogonadism, sexual dysfunction and infertility.

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Abbreviations

AMH:

Anti-Müllerian hormone

CHH:

Congenital hypogonadotrophic hypogonadism

DHEA:

Dehydroepieandrostenedione

DHEAS:

Dehydroepieandrostenedione sulphate

DHT:

Dihydrotestosterone

DSD:

Disorder of sex development

ED:

Erectile dysfunction

FSH:

Follicle stimulating hormone

GnRH:

Gonadotrophin-releasing hormone

hCG:

Human chorionic gonadotrophin

HH:

Hypogonadotrophic hypogonadism

HPG:

Hypothalamic-pituitary-gonadal

IB:

Inhibin B

INSL3:

Insulin-like peptide 3

KS:

Kallmann syndrome

LH:

Luteinizing hormone

PDE5:

Phosphodiesterase type 5

SC:

Sertoli cell

SD:

Standard deviation

SHBG:

Sex hormone binding globulin

ST:

Seminiferous tubule

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Key Reading

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Author information

Authors and Affiliations

  1. William F. Connell School of Nursing, Chesnut Hill, MA, USA

    Andrew A. Dwyer

  2. Boston College, Chesnut Hill, MA, USA

    Andrew A. Dwyer

  3. Newcastle-upon-Tyne Hospitals Foundation NHS Trust (Royal Victoria Infirmary), Institute for Human Genetics, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, UK

    Richard Quinton

Authors
  1. Andrew A. Dwyer
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  2. Richard Quinton
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Corresponding author

Correspondence to Andrew A. Dwyer .

Editor information

Editors and Affiliations

  1. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

  2. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Cecilia Follin

  3. Northwest Pituitary Center Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  4. Churchill Hospital, University of Oxford, Oxford, UK

    Ashley Grossman

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Dwyer, A.A., Quinton, R. (2019). Anatomy and Physiology of the Hypothalamic-Pituitary-Gonadal (HPG) Axis. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_43

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  • DOI: https://doi.org/10.1007/978-3-319-99817-6_43

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  • Online ISBN: 978-3-319-99817-6

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