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

  • Andrew A. DwyerEmail author
  • Richard Quinton
Chapter

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.

Keywords

Hypothalamus Pituitary Gonadotrophins Testes Spermatogenesis Testosterone Sexual function 

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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    Boehm U, Bouloux PM, Dattani MT, de Roux N, Dodé C, Dunkel L, Dwyer AA, Giacobini P, Hardelin J-P, Juul A, Maghnie M, Pitteloud N, Prevot V, Raivio T, Tena-Sempere M, Quinton R, document YJE c. European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment. Nat Rev. Endocrinol. 2015;11(9):547–64.  https://doi.org/10.1038/nrendo.2015.112.PubMedCrossRefGoogle Scholar
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    Rey RA, Grinspon RP, Gottlieb S, Pasqualini T, Knoblovits P, Aszpis S, Pacenza N, Stewart Usher J, Bergadá I, Campo SM. Male hypogonadism: an extended classification based on a developmental, endocrine physiology-based approach. Andrology. 2013;1(1):3–16.  https://doi.org/10.1111/j.2047-2927.2012.00008.x.PubMedCrossRefGoogle Scholar
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    Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, Maggi M, Nelson CJ, Parish S, Salonia A, Tan R, Mulhall JP, Hellstrom WJ. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003.  https://doi.org/10.1038/nrdp.2016.3.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.William F. Connell School of NursingChesnut HillUSA
  2. 2.Boston CollegeChesnut HillUSA
  3. 3.Newcastle-upon-Tyne Hospitals Foundation NHS Trust (Royal Victoria Infirmary), Institute for Human Genetics, University of Newcastle-upon-TyneNewcastle-upon-TyneUK

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